Minimally invasive palliative treatment of malignant tracheoesophageal fistula using cardiac septal occluder: case series analysis

Abstract

Abstract Tracheoesophageal fistula (TEF), especially advanced malignant TEF (mTEF), is commonly occurs in critically ill patients who require prolonged mechanical ventilation and are not suitable candidates for surgical intervention due to their compromised health status. The Management of these mTEF patients remain a significant challenge. This study aimed to evaluate the safety and efficacy of using a cardiac septal occluder for the closure of mTEF. 8 patients with mTEF underwent closure surgery using atrial/ventricular septal defect (ASD/VSD) septal occluders at the Respiratory Department of HuBei Yichang Central People's Hospital from 2021 to 2023. The procedure involved percutaneous placement of the occluder through the fistula to achieve closure. The study demonstrated that the use of cardiac septal occluder therapy in patients with mTEF can alleviate symptoms, improve quality of life, and enhance survival rates, with no significant complications observed. Furthermore, the study provided comprehensive details on surgical indications, preoperative evaluation and diagnosis, selection of occluder, methods of occlusion, and postoperative care. Our findings indicate that the application of cardiac septal occluder in the treatment of mTEF is a safe and effective palliative treatment. These findings provide valuable guidance for the clinical application of cardiac septal defect occluders in the management of TEF.