Key result
EZ bronchial blockers for MICS CABG carry an ~18% rate of placement challenges or complications.
Why the study?
Clinicians must recognize, prevent, and manage unexpected challenges and adverse effects associated with the EZ blocker during lung isolation.
While the EZ blocker is generally safe for lung isolation in MICS CABG, clinicians must be prepared to manage complications such as failed insertion, misplacement, hemodynamic instability, and bronchial injury.
Clinicians should anticipate complications with EZ blockers in MICS CABG; leaves open optimal lung isolation technique selection.
We present a case series of challenges and complications of using Rusch EZ blocker™ (Teleflex Life Sciences Ltd., Athlone, Ireland), a specially designed semi rigid Y shaped bronchial blocker containing two inflatable cuffs. We describe fifteen different patients (out of eighty four attempted EZ blockers) undergoing MICS CABG, in whom we faced different technical difficulties and adverse effects while using EZ blocker. We report failed EZ blocker insertion due to anatomical reasons, misplaced blocker following insertion and also few manufacturer defects. We have also encountered hemodynamic instability and bronchial injury in small percentage of cases. The EZ blocker is an easy, safe and reliable device for lung isolation but clinicians must know, prevent and solve the unexpected associated troubles which can happen acutely during insertion or insidiously post endobronchial placement.
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Maiti et al. (2024) studied Minimally invasive coronary artery bypass grafting (MICS CABG) (n=84). EZ bronchial blocker was evaluated on Challenges and complications during EZ blocker insertion and use. Among 84 attempted EZ bronchial blocker placements for MICS CABG surgery, 15 cases (17.9%) experienced challenges or complications including failed insertion, hemodynamic instability, and cuff leaks.
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