Use of Amplatzer occluders for treatment of aorto-pulmonary fistulas - case and review of the literature

Expert Rev Med Devices. 2017 Nov;14(11):845-847. doi: 10.1080/17434440.2017.1389636. Epub 2017 Oct 12.

Abstract

the use of amplatzer occluder family in daily clinical practice has already overcome on-label indications, with growing clinical experience and the technological evolution of devices. Areas covered: We present the case of a patient with a very rare complication following proximal aortic surgery treated using a unique strategy. A huge pseudoaneurysm around an ascending aortic prosthesis ruptured into the right pulmonary artery. A hybrid treatment strategy consisting of percutaneous closure of the fistula followed by cardiosurgery was chosen due to the patient's poor haemodynamic condition. We also review current clinical experience of endovascular treatment of aortopulmonary fistulas by searching case reports in PubMed. Expert commentary: Closure of the APF using an Amplatzer occluder via the antegrade venous approach is feasible, and may improve the haemodynamic conditions and decrease the risk of subsequent cardiac surgery.

Keywords: Occluder; aortic pseudoaneurysm; aorto-pulmonary fistula; endovascular treatment.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Aneurysm, False / etiology
  • Aneurysm, False / surgery*
  • Aortic Aneurysm / surgery
  • Aortic Valve Stenosis / surgery
  • Arterio-Arterial Fistula / diagnostic imaging
  • Arterio-Arterial Fistula / etiology
  • Arterio-Arterial Fistula / surgery*
  • Cardiovascular Surgical Procedures / adverse effects*
  • Endovascular Procedures
  • Humans
  • Male
  • Prosthesis Implantation
  • Pulmonary Artery / abnormalities*
  • Pulmonary Artery / diagnostic imaging
  • Pulmonary Artery / surgery
  • Septal Occluder Device*

Supplementary concepts

  • Aorta-pulmonary artery fistula