JTCVS techniques · 2025
Lung isolation using retrograde intrabronchial Fogarty catheter: Experience from 35 cases.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Hirmiz Najim Hanna, Taha Abdulsalam Yaseen
Аннотация
OBJECTIVES: One-lung ventilation is vital in thoracic surgery to improve exposure and protect the contralateral lung. Standard techniques using double-lumen tubes or bronchial blockers require specialized equipment and training, which are often unavailable in emergencies, pediatric cases, or low-resource settings. Retrograde intraoperative insertion of a Fogarty catheter into an open bronchus is a seldom-reported alternative, with only 1 previous case documented.
METHODS: We present a case series of 35 patients (25 male, 10 female; age 4-50 years, mean 28 years) who underwent thoracic surgery in Basra and Baghdad hospitals between 1984 and 2000. Lung isolation was achieved by inserting a Fogarty catheter directly into the bronchus via the surgical field. Indications included pulmonary hydatid cysts (n = 19), thoracic trauma (n = 14), and bronchopleural fistulae (n = 2). The technique was first used during the Iraqi-Iranian war in 1984 on a wounded soldier requiring lobectomy and was most recently used in 2000 on a pediatric patient with a ruptured hydatid cyst.
RESULTS: One-lung ventilation was successfully achieved in all cases without technique-related complications. Oxygenation and ventilation remained stable throughout procedures, enabling safe and effective surgical management across various thoracic conditions. No adverse events from catheter placement were reported.
CONCLUSIONS: This is the first case series-and only the second report-on retrograde Fogarty catheter insertion for lung isolation. The method is simple, safe, cost-effective, and especially useful in emergencies, pediatric surgery, and settings lacking standard equipment or trained personnel.
METHODS: We present a case series of 35 patients (25 male, 10 female; age 4-50 years, mean 28 years) who underwent thoracic surgery in Basra and Baghdad hospitals between 1984 and 2000. Lung isolation was achieved by inserting a Fogarty catheter directly into the bronchus via the surgical field. Indications included pulmonary hydatid cysts (n = 19), thoracic trauma (n = 14), and bronchopleural fistulae (n = 2). The technique was first used during the Iraqi-Iranian war in 1984 on a wounded soldier requiring lobectomy and was most recently used in 2000 on a pediatric patient with a ruptured hydatid cyst.
RESULTS: One-lung ventilation was successfully achieved in all cases without technique-related complications. Oxygenation and ventilation remained stable throughout procedures, enabling safe and effective surgical management across various thoracic conditions. No adverse events from catheter placement were reported.
CONCLUSIONS: This is the first case series-and only the second report-on retrograde Fogarty catheter insertion for lung isolation. The method is simple, safe, cost-effective, and especially useful in emergencies, pediatric surgery, and settings lacking standard equipment or trained personnel.