Large central acquired esophagorespiratory fistulas (ERFs) are life-threaten. Some patients cannot bear surgery because of poor condition. Supporting therapy, stenting, and biogel sealing may result in poor efficacy or lethal complications. In this abstract, we present our experience in treating a series cases of central ERFs with cardiac septal defect occluders and vascular plugs. The implantation was carried out by bronchoscope under conscious sedation. All patients were informed about the off-label use of Cardiac Septal Defect Occluders and Vascular Plugs (Both from Lifetech Scientific, Shenzhen, China) and signed the consent forms. 5 patients (3 males and 2 females) in the age range 55-80 years (mean, 70.2±10.28) were comfirmed to have 8 ERFs in Guangdong General Hospital (China) between September 2012 and January 2014. All patients were not qualified for surgery because of poor condition or advanced malignant diseases. The fistulas were occluded with 4 ASD Occluders, 1 VSD Occluder and 3 Vascular Plugs. All the symptoms related to the ERFs disappeared after the fistulas closure and the clinical condition improved significantly. Although the double-disk metallic septal occluder shows good stability after deploy, it has a high-profile ″shearing″ force. After the procedure, 5 occluders protruded into the lumen of the airway and the esophagus, caused the fistulas recanalization whithin one year. In conclusion, this procedure maybe effective in selective patients in a short-term. However, excision of the fistula with repair of the esophageal and tracheobronchial defects after the occlusion procedure needs to be considered when the patient's condition improved.
Li et al. (Mon,) studied this question.
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