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Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient

Received: 22 February 2024    Accepted: 7 April 2024    Published: 28 April 2024
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Abstract

Purpose: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare anomalies in neonates that must be surgically repaired by esophageal reconstruction with or without ligation of the fistula. Recurrent tracheoesophageal fistula (rTEF) occurs in 3-15% of primary surgical repairs in esophageal atresia; it is associated with recurrent hospital admissions and up to 27% short term mortality. Dependable reparation very often proves difficult by standard surgical techniques. Using oesophageal fully covered self-expandable metal stents in adult patients yields a <50% efficacy and other endoscopic techniques such as occlusion by clips or glue show no better results. A minimally invasive alternative is the use of vascular plug septal occluders. We report the efficacy of endoscopic placement of a cardiac septal occluder (CSO) in a paediatric patient. Clinical case: A 12-year-old female with recurrent (rTEF) and refractory tracheoesophageal fistula (refTEF) was subjected to an refTEF closure procedure via endoscopic placement of a cardiac septal occlusion device. Conclusion: Debate regarding the gold standard of rTEF treatment closure a hot debate but flexible endoscopy is an accepted alternative. This report describes the successful fixing of a refTEF using a cardiac septal occluder. After four weeks follow up, no re-incidence of the tracheoesophageal fistula was detected. The results advocate for the endoscopic closure of refractory tracheoesophageal fistula with cardiac occluders in children thus establishing a promising therapeutical alternative in refTEF in paediatric population patients.

Published in American Journal of Pediatrics (Volume 10, Issue 2)
DOI 10.11648/j.ajp.20241002.15
Page(s) 75-80
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Tracheoesophageal Fistula, Recurrent Tracheoesophageal Fistula, Refractory Tracheoesophageal Fistula, Endoscopic Interventional Therapies, Treatment, Children, Cardiac Septal Occluder

References
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Cite This Article
  • APA Style

    Alfredo, C. R., Antonio, S., Jesús, G. J., Alejandro, R. R., Servando, G. M., et al. (2024). Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient. American Journal of Pediatrics, 10(2), 75-80. https://doi.org/10.11648/j.ajp.20241002.15

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    ACS Style

    Alfredo, C. R.; Antonio, S.; Jesús, G. J.; Alejandro, R. R.; Servando, G. M., et al. Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient. Am. J. Pediatr. 2024, 10(2), 75-80. doi: 10.11648/j.ajp.20241002.15

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    AMA Style

    Alfredo CR, Antonio S, Jesús GJ, Alejandro RR, Servando GM, et al. Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient. Am J Pediatr. 2024;10(2):75-80. doi: 10.11648/j.ajp.20241002.15

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  • @article{10.11648/j.ajp.20241002.15,
      author = {Castañeda-Ortiz Ramon Alfredo and Salgado-Sandoval Antonio and Gutiérrez-Escobedo José Jesús and Rodríguez-Izaguirre Rodrigo Alejandro and Gallardo-Luna Miguel Servando and Meza-Gallegos Analí and Flores-Arizmendi Ramon Alejandro and Montalvo-Aguilar Jesús Francisco and Terriquez-Rodríguez Sergio},
      title = {Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient
    },
      journal = {American Journal of Pediatrics},
      volume = {10},
      number = {2},
      pages = {75-80},
      doi = {10.11648/j.ajp.20241002.15},
      url = {https://doi.org/10.11648/j.ajp.20241002.15},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20241002.15},
      abstract = {Purpose: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare anomalies in neonates that must be surgically repaired by esophageal reconstruction with or without ligation of the fistula. Recurrent tracheoesophageal fistula (rTEF) occurs in 3-15% of primary surgical repairs in esophageal atresia; it is associated with recurrent hospital admissions and up to 27% short term mortality. Dependable reparation very often proves difficult by standard surgical techniques. Using oesophageal fully covered self-expandable metal stents in adult patients yields a <50% efficacy and other endoscopic techniques such as occlusion by clips or glue show no better results. A minimally invasive alternative is the use of vascular plug septal occluders. We report the efficacy of endoscopic placement of a cardiac septal occluder (CSO) in a paediatric patient. Clinical case: A 12-year-old female with recurrent (rTEF) and refractory tracheoesophageal fistula (refTEF) was subjected to an refTEF closure procedure via endoscopic placement of a cardiac septal occlusion device. Conclusion: Debate regarding the gold standard of rTEF treatment closure a hot debate but flexible endoscopy is an accepted alternative. This report describes the successful fixing of a refTEF using a cardiac septal occluder. After four weeks follow up, no re-incidence of the tracheoesophageal fistula was detected. The results advocate for the endoscopic closure of refractory tracheoesophageal fistula with cardiac occluders in children thus establishing a promising therapeutical alternative in refTEF in paediatric population patients.
    },
     year = {2024}
    }
    

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  • TY  - JOUR
    T1  - Endoscopic Repair of Refractory Tracheoesophageal Fistula with a Cardiac Septal Occluder Device in a 12 Years-Old Patient
    
    AU  - Castañeda-Ortiz Ramon Alfredo
    AU  - Salgado-Sandoval Antonio
    AU  - Gutiérrez-Escobedo José Jesús
    AU  - Rodríguez-Izaguirre Rodrigo Alejandro
    AU  - Gallardo-Luna Miguel Servando
    AU  - Meza-Gallegos Analí
    AU  - Flores-Arizmendi Ramon Alejandro
    AU  - Montalvo-Aguilar Jesús Francisco
    AU  - Terriquez-Rodríguez Sergio
    Y1  - 2024/04/28
    PY  - 2024
    N1  - https://doi.org/10.11648/j.ajp.20241002.15
    DO  - 10.11648/j.ajp.20241002.15
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 75
    EP  - 80
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20241002.15
    AB  - Purpose: Esophageal atresia (EA) and tracheoesophageal fistula (TEF) are rare anomalies in neonates that must be surgically repaired by esophageal reconstruction with or without ligation of the fistula. Recurrent tracheoesophageal fistula (rTEF) occurs in 3-15% of primary surgical repairs in esophageal atresia; it is associated with recurrent hospital admissions and up to 27% short term mortality. Dependable reparation very often proves difficult by standard surgical techniques. Using oesophageal fully covered self-expandable metal stents in adult patients yields a <50% efficacy and other endoscopic techniques such as occlusion by clips or glue show no better results. A minimally invasive alternative is the use of vascular plug septal occluders. We report the efficacy of endoscopic placement of a cardiac septal occluder (CSO) in a paediatric patient. Clinical case: A 12-year-old female with recurrent (rTEF) and refractory tracheoesophageal fistula (refTEF) was subjected to an refTEF closure procedure via endoscopic placement of a cardiac septal occlusion device. Conclusion: Debate regarding the gold standard of rTEF treatment closure a hot debate but flexible endoscopy is an accepted alternative. This report describes the successful fixing of a refTEF using a cardiac septal occluder. After four weeks follow up, no re-incidence of the tracheoesophageal fistula was detected. The results advocate for the endoscopic closure of refractory tracheoesophageal fistula with cardiac occluders in children thus establishing a promising therapeutical alternative in refTEF in paediatric population patients.
    
    VL  - 10
    IS  - 2
    ER  - 

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