Endovascular Management of a Left Subclavian Artery Lesion Following Thoracoplasty for Bronchopleural Fistula and Empyema Secondary to Aspergillus fumigatus

Ramos, Ricard; Rodríguez, Laura; Saumench, Josep; Iborra, Elena; Cairols, Marc Antoni; Dorca, Jordi

doi:10.1016/S1579-2129(08)60055-5

Archivos de Bronconeumología

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Vol. 44. Issue 6.

Pages 338-340 (January 2008)

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Pages 338-340 (January 2008)

Case Report

DOI: 10.1016/S1579-2129(08)60055-5

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Endovascular Management of a Left Subclavian Artery Lesion Following Thoracoplasty for Bronchopleural Fistula and Empyema Secondary to Aspergillus fumigatus

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Ricard Ramosa,

Corresponding author

ricardramos@ub.edu

Correspondence: Dr R. Ramos Servei de Cirurgia Toràcica, Hospital Universitari de Bellvitge Feixa Llarga, s/n08907 L'Hospitalet de Llobregat Barcelona, Spain

, Laura Rodríguezb, Josep Saumenchc, Elena Iborrab, Marc Antoni Cairolsb, Jordi Dorcad

a Unitat d'Anatomia i Embriologia Humana, Servei de Cirurgia Toràcica, Hospital Universitari de Bellvitge, Universidad de Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain

b Servei d'Angiologia i Cirurgia Vascular, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain

c Servei de Cirurgia Toràcica, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain

d Servei de Pneumologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain

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Massive and/or recurrent hemoptysis is a clear indicationfor surgical treatment of pleuropulmonary aspergilloma, despitethe incidence of postoperative morbidity and mortality. Thoracoplasty has been widely used for 20 years and is stillindicated in these cases, following lobectomy, even though theprocedure is not free of complications. We report the case of a patient who required thoracoplasty to treat apleuropulmonary aspergilloma invading the chest wall. Subsequent placement of an aortic stent-graft was requireddue to tearing of the left subclavian artery.

Key words:

Pulmonary aspergilloma

Thoracoplasty

Thoracicaortic stent-graft

La hemoptisis masiva y/o repetitiva es una indicación cla-ra de tratamiento quirúrgico del aspergiloma pleuropulmo-nar, a pesar de la morbimortalidad posquirúrgica existente. La toracoplastia, muy utilizada hace 2 décadas, todavía tie-ne su indicación aquí, tras lobectomía, aunque no está exen-ta de complicaciones. Presentamos un caso de aspergilomapleuropulmonar con invasión de pared torácica que requi-rió toracoplastia y posteriormente técnicas endovascularesaórticas por desgarro de la arteria subclavia izquierda.

Palabras clave:

Aspergiloma pulmonar

Toracoplastia

Endoprótesisde aorta torácica

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