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

ABSTRACT

Introduction: 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
• aorto-pulmonary fistula
• endovascular treatment
• aortic pseudoaneurysm

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Additional information

Funding

This work was supported by the Charles University Research Program Q38.