Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.06.030
Vishal N. Shah DO , Katelin C. McLeod NP , Bernard J. Wortman NP , Joe H. Johnson MD
{"title":"Herniation of a Giant Emphysematous Bulla Through a Tube Thoracostomy Site","authors":"Vishal N. Shah DO , Katelin C. McLeod NP , Bernard J. Wortman NP , Joe H. Johnson MD","doi":"10.1016/j.atssr.2025.06.030","DOIUrl":"10.1016/j.atssr.2025.06.030","url":null,"abstract":"","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 916-917"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.05.002
Kaylan N. Gee MD , Todd L. Demmy MD , Kenneth Patrick Seastedt MD, MBA
A 54-year-old female patient presented with a symptomatic esophageal diverticulum. Endoscopy and biopsy confirmed a communicating esophageal duplication cyst with Barrett metaplasia and low-grade dysplasia. There was no evidence of fluorodeoxyglucose avidity on the preoperative positron emission tomography scan. Given recent trends towards esophageal preservation and absence of definitive cancer, cyst resection was planned. Final pathology revealed invasive adenocarcinoma; thus, esophagectomy was performed. We present a rare case of an esophageal duplication cyst progressing to invasive adenocarcinoma, focusing on the key surgical decision points in balancing oncologic control and esophageal preservation.
{"title":"Factors Favoring Esophagectomy for Communicating Duplication Cysts","authors":"Kaylan N. Gee MD , Todd L. Demmy MD , Kenneth Patrick Seastedt MD, MBA","doi":"10.1016/j.atssr.2025.05.002","DOIUrl":"10.1016/j.atssr.2025.05.002","url":null,"abstract":"<div><div>A 54-year-old female patient presented with a symptomatic esophageal diverticulum. Endoscopy and biopsy confirmed a communicating esophageal duplication cyst with Barrett metaplasia and low-grade dysplasia. There was no evidence of fluorodeoxyglucose avidity on the preoperative positron emission tomography scan. Given recent trends towards esophageal preservation and absence of definitive cancer, cyst resection was planned. Final pathology revealed invasive adenocarcinoma; thus, esophagectomy was performed. We present a rare case of an esophageal duplication cyst progressing to invasive adenocarcinoma, focusing on the key surgical decision points in balancing oncologic control and esophageal preservation.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 929-931"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.05.009
Antonia Kreso MD, PhD , Christina L. Costantino MD , Derek Loneman MD , Bianca Christensen MD , Bailey Hutchison MD , Anthony Mattia MD , Ingrid Bassett MD, MPH , David Berkman MD , Hugh G. Auchincloss MD , Uma M. Sachdeva MD, PhD
Mucormycosis is a fungal infection typically affecting persons with immunocompromise. Gastrointestinal infection of immunocompetent hosts is exceedingly rare. We report a case of gastroesophageal mucormycosis in an immunocompetent host that manifested as gastric necrosis within an incarcerated paraesophageal hernia. The patient was managed with resection, requiring subtotal gastrectomy and esophagectomy, and prompt antifungal treatment, resulting in full recovery.
{"title":"Gastroesophageal Mucormycosis in an Immunocompetent Host Within Incarcerated Paraesophageal Hernia","authors":"Antonia Kreso MD, PhD , Christina L. Costantino MD , Derek Loneman MD , Bianca Christensen MD , Bailey Hutchison MD , Anthony Mattia MD , Ingrid Bassett MD, MPH , David Berkman MD , Hugh G. Auchincloss MD , Uma M. Sachdeva MD, PhD","doi":"10.1016/j.atssr.2025.05.009","DOIUrl":"10.1016/j.atssr.2025.05.009","url":null,"abstract":"<div><div>Mucormycosis is a fungal infection typically affecting persons with immunocompromise. Gastrointestinal infection of immunocompetent hosts is exceedingly rare. We report a case of gastroesophageal mucormycosis in an immunocompetent host that manifested as gastric necrosis within an incarcerated paraesophageal hernia. The patient was managed with resection, requiring subtotal gastrectomy and esophagectomy, and prompt antifungal treatment, resulting in full recovery.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 946-949"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 73-year-old woman with history of severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) with a size 23 self-expandable valve 5 years ago presented with symptomatic severe bioprosthetic aortic stenosis. Given the small aortic annulus and high risk for coronary occlusion in a valve-in-valve procedure, she underwent TAVR explantation, surgical aortic valve replacement with aortic root enlargement to put in a size 23 surgical bioprosthetic aortic valve, and ascending aorta replacement due to the injury of intima in the ascending aorta. Her recovery was complicated by complete heart block. She required permanent pacemaker placement on postoperative day 1 and was discharged home on postoperative day 7.
{"title":"Surgical Explantation of Stenotic Self-Expandable Transcatheter Aortic Valve With Aortic Root Enlargement","authors":"Junyi Liu BS , Eduardo Danduch MD , Saeed Tarabichi MD , Sanjay Samy MD , Chikashi Nakai MD","doi":"10.1016/j.atssr.2025.06.004","DOIUrl":"10.1016/j.atssr.2025.06.004","url":null,"abstract":"<div><div>A 73-year-old woman with history of severe aortic stenosis who underwent transcatheter aortic valve replacement (TAVR) with a size 23 self-expandable valve 5 years ago presented with symptomatic severe bioprosthetic aortic stenosis. Given the small aortic annulus and high risk for coronary occlusion in a valve-in-valve procedure, she underwent TAVR explantation, surgical aortic valve replacement with aortic root enlargement to put in a size 23 surgical bioprosthetic aortic valve, and ascending aorta replacement due to the injury of intima in the ascending aorta. Her recovery was complicated by complete heart block. She required permanent pacemaker placement on postoperative day 1 and was discharged home on postoperative day 7.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1070-1073"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145645715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.05.007
Shi Nan Feng BSPH , Alexandra Rizaldi BA , Atharv Oak MEng , Alice L. Zhou MS , Armaan F. Akbar BS , Jessica M. Ruck MD , Ahmet Kilic MD
Background
Infection is a major cause of morbidity and mortality after heart transplantation (HT). Recent trends in post-HT infection demand further investigation, particularly given effects of the coronavirus disease 2019 (COVID-19) pandemic.
Methods
We identified all adult HT recipients in the United States from October 18, 2018, to June 30, 2023, using Organ Procurement and Transplantation Network data. We categorized transplants into 3 eras, accounting for COVID-19: October 2018 to March 2020, March 2020 to March 2022, and after March 2022. Survival was compared using Kaplan-Meier survival analysis and Cox proportional hazards regression. Readmission hospitalizations for infection in the first year after HT were compared using multivariable logistic regression, adjusted for era and donor and recipient characteristics.
Results
Of 13,663 patients who received HT (median age, 57 years; 72.9% men), hospitalization for infection in the first year after transplant was 2.9% (n = 3645) for patients who received a transplant in October 2018 to March 2020, 5.4% (n = 5658) for patients who received a transplant in March 2020 to March 2022 and 11.6% (n = 4360) for patients who received a transplant after March 2022 (P < .001). Compared with patients who received a transplant between October 2018 and March 2020, patients who received a transplant during March 2020 to March 2022 (adjusted odds ratio, 1.91; 95% CI, 1.51-2.41) and after March 2022 (adjusted odds ratio, 4.37; 95% CI, 3.30-5.78) eras were more likely to be hospitalized for infection in their first year after HT. After adjusting for covariates, we found no significant difference in the risk of death for recipients who received a transplant from March 2020 to March 2022 (adjusted hazard ratio, 0.86; 95% CI, 0.67-1.11; P = .257) or after March 2022 (adjusted hazard ratio, 1.01; 95% CI, 0.73-1.39, P = .955) compared with March 2018 to March 2020.
Conclusions
Odds of hospitalization for infection in the first year after HT performed between March 2020 and March 2022 and after March 2022 were 1.91 and 4.37 times as high, respectively, as HT performed between October 2018 and March 2020.
{"title":"Recent Trends in Hospitalizations for Infection in the First Year After Heart Transplantation","authors":"Shi Nan Feng BSPH , Alexandra Rizaldi BA , Atharv Oak MEng , Alice L. Zhou MS , Armaan F. Akbar BS , Jessica M. Ruck MD , Ahmet Kilic MD","doi":"10.1016/j.atssr.2025.05.007","DOIUrl":"10.1016/j.atssr.2025.05.007","url":null,"abstract":"<div><h3>Background</h3><div>Infection is a major cause of morbidity and mortality after heart transplantation (HT). Recent trends in post-HT infection demand further investigation, particularly given effects of the coronavirus disease 2019 (COVID-19) pandemic.</div></div><div><h3>Methods</h3><div>We identified all adult HT recipients in the United States from October 18, 2018, to June 30, 2023, using Organ Procurement and Transplantation Network data. We categorized transplants into 3 eras, accounting for COVID-19: October 2018 to March 2020, March 2020 to March 2022, and after March 2022. Survival was compared using Kaplan-Meier survival analysis and Cox proportional hazards regression. Readmission hospitalizations for infection in the first year after HT were compared using multivariable logistic regression, adjusted for era and donor and recipient characteristics.</div></div><div><h3>Results</h3><div>Of 13,663 patients who received HT (median age, 57 years; 72.9% men), hospitalization for infection in the first year after transplant was 2.9% (n = 3645) for patients who received a transplant in October 2018 to March 2020, 5.4% (n = 5658) for patients who received a transplant in March 2020 to March 2022 and 11.6% (n = 4360) for patients who received a transplant after March 2022 (<em>P</em> < .001). Compared with patients who received a transplant between October 2018 and March 2020, patients who received a transplant during March 2020 to March 2022 (adjusted odds ratio, 1.91; 95% CI, 1.51-2.41) and after March 2022 (adjusted odds ratio, 4.37; 95% CI, 3.30-5.78) eras were more likely to be hospitalized for infection in their first year after HT. After adjusting for covariates, we found no significant difference in the risk of death for recipients who received a transplant from March 2020 to March 2022 (adjusted hazard ratio, 0.86; 95% CI, 0.67-1.11; <em>P</em> = .257) or after March 2022 (adjusted hazard ratio, 1.01; 95% CI, 0.73-1.39, <em>P</em> = .955) compared with March 2018 to March 2020.</div></div><div><h3>Conclusions</h3><div>Odds of hospitalization for infection in the first year after HT performed between March 2020 and March 2022 and after March 2022 were 1.91 and 4.37 times as high, respectively, as HT performed between October 2018 and March 2020.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1124-1128"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.05.016
Shuya Chen MD , Christoph Zacherl MD , Giulia Benedetti MD , Andrea Bille MD
Bronchial artery aneurysms (BAAs) are rare vascular anomalies categorized as mediastinal, intrapulmonary, or combined. Although they are typically asymptomatic, rupture can result in life-threatening complications necessitating immediate intervention, commonly by transcatheter arterial embolization. We describe a 59-year-old woman presenting with intermittent hemoptysis lasting >1 month. Computed tomography revealed a 12 × 8 × 7-mm mediastinal BAA located in the aortopulmonary window. Successful aneurysm resection was performed by robot-assisted thoracoscopic surgery clipping, with minimal blood loss and uneventful postoperative recovery. Robot-assisted thoracoscopic surgery clipping is an effective alternative for anatomically complex BAAs challenging for conventional embolization.
{"title":"Robot-Assisted Thoracoscopic Clipping of a Mediastinal Bronchial Artery Aneurysm","authors":"Shuya Chen MD , Christoph Zacherl MD , Giulia Benedetti MD , Andrea Bille MD","doi":"10.1016/j.atssr.2025.05.016","DOIUrl":"10.1016/j.atssr.2025.05.016","url":null,"abstract":"<div><div>Bronchial artery aneurysms (BAAs) are rare vascular anomalies categorized as mediastinal, intrapulmonary, or combined. Although they are typically asymptomatic, rupture can result in life-threatening complications necessitating immediate intervention, commonly by transcatheter arterial embolization. We describe a 59-year-old woman presenting with intermittent hemoptysis lasting >1 month. Computed tomography revealed a 12 × 8 × 7-mm mediastinal BAA located in the aortopulmonary window. Successful aneurysm resection was performed by robot-assisted thoracoscopic surgery clipping, with minimal blood loss and uneventful postoperative recovery. Robot-assisted thoracoscopic surgery clipping is an effective alternative for anatomically complex BAAs challenging for conventional embolization.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 982-984"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.04.017
Mohammed Abed MD, MPH , Miho Fukui MD, PhD , Mario Goessl MD , Vinayak N. Bapat MD
In patients with ascending aortic pseudoaneurysm, invasive treatment is required regardless of size. The choice between surgical and percutaneous intervention depends on surgical risk and anatomy. Surgical repair, though the gold standard, has a high mortality rate and involves redo sternotomy and cardiopulmonary bypass. Percutaneous closure is an alternative for high-risk patients, using devices like septal occluders, vascular plugs, stent grafts, and coil embolization, selected based on the pseudoaneurysm’s characteristics. This case demonstrates the technique of atrial septal defect occluders for aortic pseudoaneurysms in high-risk patients, offering a good alternative to open repair.
{"title":"Minimally Invasive Aortic Pseudoaneurysm Repair with Atrial Septal Defect Occluder","authors":"Mohammed Abed MD, MPH , Miho Fukui MD, PhD , Mario Goessl MD , Vinayak N. Bapat MD","doi":"10.1016/j.atssr.2025.04.017","DOIUrl":"10.1016/j.atssr.2025.04.017","url":null,"abstract":"<div><div>In patients with ascending aortic pseudoaneurysm, invasive treatment is required regardless of size. The choice between surgical and percutaneous intervention depends on surgical risk and anatomy. Surgical repair, though the gold standard, has a high mortality rate and involves redo sternotomy and cardiopulmonary bypass. Percutaneous closure is an alternative for high-risk patients, using devices like septal occluders, vascular plugs, stent grafts, and coil embolization, selected based on the pseudoaneurysm’s characteristics. This case demonstrates the technique of atrial septal defect occluders for aortic pseudoaneurysms in high-risk patients, offering a good alternative to open repair.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 997-999"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01DOI: 10.1016/j.atssr.2025.04.015
Ayesha P. Ng MD, MPH , Joseph E. Hadaya MD, PhD , Esteban Aguayo MD , Konmal Ali BS , Troy N. Coaston BS , Peyman Benharash MD
Background
Despite the increasing prevalence of tricuspid valve (TV) regurgitation, surgical interventions remain low, potentially due to high operative mortality. Given the lack of contemporary data, we examined trends in utilization and outcomes after isolated and concomitant TV operations.
Methods
Adults undergoing TV repair/replacement were identified in the 2016-2021 National Inpatient Sample. Patients undergoing heart transplantation, ventricular assist device placement, or with endocarditis were excluded. Study cohorts were stratified based on Isolated vs concomitant TV surgery (TV-Mitral, TV-Aortic, TV-coronary artery bypass grafting [CABG]). Multivariable mixed regressions were developed to evaluate the association of concomitant surgery with major adverse events including mortality and complications, costs, and length of stay.
Results
Of 51,940 patients, 19.2% underwent Isolated TV, 47.2% TV-Mitral, 14.6% TV-Aortic, and 19.0% TV-CABG operations. The volume of Isolated TV procedures significantly increased from 1415 in 2016 to 1830 in 2021 (P = .001). Compared with Isolated TV, patients undergoing concomitant operations were older with greater burden of comorbidities. TV-CABG and TV-Aortic patients experienced higher major adverse event rates of 67.6% and 56.5%, respectively, compared with 46.1% and 50.1% among TV-Mitral and Isolated TV (P < .001). Furthermore, TV-CABG and TV-Aortic cohorts experienced greater length of stay, costs, and nonhome discharge relative to TV-Mitral and Isolated TV, which were comparable. After adjustment, major adverse event rates significantly decreased over time among TV-CABG and remained stable among all other groups.
Conclusions
Utilization of isolated tricuspid surgery is rising, with comparable complications and resource use relative to concomitant mitral operations. Given the lack of improvement in postoperative morbidity over time, further optimization of tricuspid surgical timing is warranted.
{"title":"Trends in Utilization and Outcomes of Isolated and Concomitant Tricuspid Valve Surgery in the United States","authors":"Ayesha P. Ng MD, MPH , Joseph E. Hadaya MD, PhD , Esteban Aguayo MD , Konmal Ali BS , Troy N. Coaston BS , Peyman Benharash MD","doi":"10.1016/j.atssr.2025.04.015","DOIUrl":"10.1016/j.atssr.2025.04.015","url":null,"abstract":"<div><h3>Background</h3><div>Despite the increasing prevalence of tricuspid valve (TV) regurgitation, surgical interventions remain low, potentially due to high operative mortality. Given the lack of contemporary data, we examined trends in utilization and outcomes after isolated and concomitant TV operations.</div></div><div><h3>Methods</h3><div>Adults undergoing TV repair/replacement were identified in the 2016-2021 National Inpatient Sample. Patients undergoing heart transplantation, ventricular assist device placement, or with endocarditis were excluded. Study cohorts were stratified based on Isolated vs concomitant TV surgery (TV-Mitral, TV-Aortic, TV-coronary artery bypass grafting [CABG]). Multivariable mixed regressions were developed to evaluate the association of concomitant surgery with major adverse events including mortality and complications, costs, and length of stay.</div></div><div><h3>Results</h3><div>Of 51,940 patients, 19.2% underwent Isolated TV, 47.2% TV-Mitral, 14.6% TV-Aortic, and 19.0% TV-CABG operations. The volume of Isolated TV procedures significantly increased from 1415 in 2016 to 1830 in 2021 (<em>P</em> = .001). Compared with Isolated TV, patients undergoing concomitant operations were older with greater burden of comorbidities. TV-CABG and TV-Aortic patients experienced higher major adverse event rates of 67.6% and 56.5%, respectively, compared with 46.1% and 50.1% among TV-Mitral and Isolated TV (<em>P</em> < .001). Furthermore, TV-CABG and TV-Aortic cohorts experienced greater length of stay, costs, and nonhome discharge relative to TV-Mitral and Isolated TV, which were comparable. After adjustment, major adverse event rates significantly decreased over time among TV-CABG and remained stable among all other groups.</div></div><div><h3>Conclusions</h3><div>Utilization of isolated tricuspid surgery is rising, with comparable complications and resource use relative to concomitant mitral operations. Given the lack of improvement in postoperative morbidity over time, further optimization of tricuspid surgical timing is warranted.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 1017-1022"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bronchial occlusion with an endobronchial Watanabe spigot (EWS) is an effective intervention for managing persistent air leak. Severe complications associated with EWS are uncommon. We highlight a rare case of EWS migration into the pleural cavity following bronchial occlusion for persistent air leak in a patient with acute respiratory distress syndrome secondary to influenza pneumonia after blunt chest trauma. The patient underwent successful video-assisted thoracoscopic surgery for EWS retrieval and pulmonary fistula repair, resulting in an uneventful recovery without recurrence of pneumothorax. This case underscores the importance of appropriate spigot selection, anatomic assessment, and vigilant monitoring in structurally compromised lungs.
{"title":"Intrapleural Migration of an Endobronchial Watanabe Spigot: Persistent Air Leak and Surgical Retrieval","authors":"Yoshiki Chiba MD, PhD , Masahiro Miyajima MD, PhD , Kazuya Honda MD , Kazuki Sato MD , Takeshi Ohyu MD , Yuki Takahashi MD, PhD , Ryunosuke Maki MD, PhD , Atsushi Watanabe MD, PhD","doi":"10.1016/j.atssr.2025.06.022","DOIUrl":"10.1016/j.atssr.2025.06.022","url":null,"abstract":"<div><div>Bronchial occlusion with an endobronchial Watanabe spigot (EWS) is an effective intervention for managing persistent air leak. Severe complications associated with EWS are uncommon. We highlight a rare case of EWS migration into the pleural cavity following bronchial occlusion for persistent air leak in a patient with acute respiratory distress syndrome secondary to influenza pneumonia after blunt chest trauma. The patient underwent successful video-assisted thoracoscopic surgery for EWS retrieval and pulmonary fistula repair, resulting in an uneventful recovery without recurrence of pneumothorax. This case underscores the importance of appropriate spigot selection, anatomic assessment, and vigilant monitoring in structurally compromised lungs.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 904-907"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Patients undergoing peritoneal dialysis may experience pleuroperitoneal communication caused by increased intraabdominal pressure from dialysis fluid. Even if the fistula is surgically closed, recurrence is common, sometimes requiring a switch to hemodialysis. One cause of recurrence is the difficulty in identifying the microfistula intraoperatively. During thoracoscopic fistula closure in the patient described in this case report, indigo carmine was used to identify the fistula and indocyanine green was then used to confirm closure. As a result of using this efficient and reliable method, pleuroperitoneal communication has not recurred for 2 months postoperatively.
{"title":"A New Intraoperative Method for Detecting Fistulas in Patients With Peritoneal Dialysis-Associated Pleuroperitoneal Communication","authors":"Yu Suyama MD , Tomonari Kinoshita MD, PhD , Ai Otani MD , Yo Tsukamoto MD , Takamasa Shibazaki MD, PhD , Takeo Nakada MD, PhD , Takashi Ohtsuka MD, PhD","doi":"10.1016/j.atssr.2025.04.011","DOIUrl":"10.1016/j.atssr.2025.04.011","url":null,"abstract":"<div><div>Patients undergoing peritoneal dialysis may experience pleuroperitoneal communication caused by increased intraabdominal pressure from dialysis fluid. Even if the fistula is surgically closed, recurrence is common, sometimes requiring a switch to hemodialysis. One cause of recurrence is the difficulty in identifying the microfistula intraoperatively. During thoracoscopic fistula closure in the patient described in this case report, indigo carmine was used to identify the fistula and indocyanine green was then used to confirm closure. As a result of using this efficient and reliable method, pleuroperitoneal communication has not recurred for 2 months postoperatively.</div></div>","PeriodicalId":72234,"journal":{"name":"Annals of thoracic surgery short reports","volume":"3 4","pages":"Pages 943-945"},"PeriodicalIF":0.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145646065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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