Fiberoptic bronchoplasty; Description of a simple adjunct technique for the management of bronchial stenosis following lung transplantation

Bronchostenosis is a well-recognized complication of pulmonary transplantation occurring at the site of the anastomosis and occasionally spreading distally from the original site of obstruction. The management of these airway complications has relied heavily on stent placement that usually involves the use of a rigid bronchoscope and is a relatively complicated procedure in the patient requiring mechanical ventilation. Another has been the use of laser therapy in selected patients. We report three cases of postoperative bronchostenosis managed with bronchoscopically directed balloon dilatation. This relatively simple procedure performed under local anesthesia using a fiber-optic bronchoscope and a modification of the Seldinger technique for balloon placement permitted accurate and atraumatic dilatation of significant posttransplant stenosis. This technique may have potential for emergency and/or palliative management of postoperative, posttraumatic, or malignant airway obstruction.