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Pulmonary vein to esophageal fistula after staged hybrid totally thoracoscopic surgical and percutaneous radiofrequency catheter ablation: a case report.

Park BJ, Kim YH, Jeong DS, Choi YS, On YK - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: A case of a fistula running from the pulmonary vein to the esophagus after a staged hybrid procedure combining total thoracoscopic ablation and percutaneous radiofrequency catheter ablation has not been reported previously.We describe such a case in a 37-year-old man who was successfully treated by surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.

ABSTRACT
A case of a fistula running from the pulmonary vein to the esophagus after a staged hybrid procedure combining total thoracoscopic ablation and percutaneous radiofrequency catheter ablation has not been reported previously. We describe such a case in a 37-year-old man who was successfully treated by surgery.

No MeSH data available.


Related in: MedlinePlus

Intraoperative photograph of the fistula between the anterior surface of the esophagus and the right lower pulmonary vein after division.
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f2-kjtcvs-47-560: Intraoperative photograph of the fistula between the anterior surface of the esophagus and the right lower pulmonary vein after division.

Mentions: An urgent surgical intervention was performed due to our high level of suspicion for a left atrial or pulmonary venous-esophageal fistula. The right femoral area was prepared for the possibility of an emergent cardiopulmonary bypass. The chest was opened through the fifth intercostal space via a right posterolateral thoracotomy under one-lung ventilation with a double lumen endotracheal tube. After anteriorly retracting the lung, a meticulous dissection of the posterior mediastinum between the esophagus, right upper and lower pulmonary veins, and left atrium was performed. A fistula 2 to 3 mm in diameter was discovered between the right lower pulmonary vein and anterior surface of the esophagus. The fistula was divided with Metzenbaum scissors (Fig. 2). Surprisingly, there was no bleeding from the fistula on the side of the right lower pulmonary vein. The internal orifice was very small, with a diameter of approximately 1 mm. The right lower pulmonary vein was repaired with a bovine pericardial patch, covered, and fixed with continuous poly-propylene sutures. After repairing the right lower pulmonary vein, we consulted our hospital’s thoracic surgeon about repairing the fistula opening on the esophageal side. He decided to carry out a primary repair of this defect because the defect site was small and relatively clear. The fistula was carefully debrided and repaired with intermittent 4-0 black silk sutures.


Pulmonary vein to esophageal fistula after staged hybrid totally thoracoscopic surgical and percutaneous radiofrequency catheter ablation: a case report.

Park BJ, Kim YH, Jeong DS, Choi YS, On YK - Korean J Thorac Cardiovasc Surg (2014)

Intraoperative photograph of the fistula between the anterior surface of the esophagus and the right lower pulmonary vein after division.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279838&req=5

f2-kjtcvs-47-560: Intraoperative photograph of the fistula between the anterior surface of the esophagus and the right lower pulmonary vein after division.
Mentions: An urgent surgical intervention was performed due to our high level of suspicion for a left atrial or pulmonary venous-esophageal fistula. The right femoral area was prepared for the possibility of an emergent cardiopulmonary bypass. The chest was opened through the fifth intercostal space via a right posterolateral thoracotomy under one-lung ventilation with a double lumen endotracheal tube. After anteriorly retracting the lung, a meticulous dissection of the posterior mediastinum between the esophagus, right upper and lower pulmonary veins, and left atrium was performed. A fistula 2 to 3 mm in diameter was discovered between the right lower pulmonary vein and anterior surface of the esophagus. The fistula was divided with Metzenbaum scissors (Fig. 2). Surprisingly, there was no bleeding from the fistula on the side of the right lower pulmonary vein. The internal orifice was very small, with a diameter of approximately 1 mm. The right lower pulmonary vein was repaired with a bovine pericardial patch, covered, and fixed with continuous poly-propylene sutures. After repairing the right lower pulmonary vein, we consulted our hospital’s thoracic surgeon about repairing the fistula opening on the esophageal side. He decided to carry out a primary repair of this defect because the defect site was small and relatively clear. The fistula was carefully debrided and repaired with intermittent 4-0 black silk sutures.

Bottom Line: A case of a fistula running from the pulmonary vein to the esophagus after a staged hybrid procedure combining total thoracoscopic ablation and percutaneous radiofrequency catheter ablation has not been reported previously.We describe such a case in a 37-year-old man who was successfully treated by surgery.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine.

ABSTRACT
A case of a fistula running from the pulmonary vein to the esophagus after a staged hybrid procedure combining total thoracoscopic ablation and percutaneous radiofrequency catheter ablation has not been reported previously. We describe such a case in a 37-year-old man who was successfully treated by surgery.

No MeSH data available.


Related in: MedlinePlus