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In a pioneering intervention carried out at Puerta de Hierro Majadahonda University Hospital, the Dr Alberto Herreros de Tejada, Head of the Endoscopy Unit at GASTEIZ, along with a multidisciplinary team of specialists, achieved Save the life of an 84-year-old woman using an innovative procedure that combined endoscopy, bronchoscopy and interventional cardiology.
The patient, previously treated for an early-stage oesophageal tumour six centimetres in size, suffered the complication of a chronic fistula (an abnormal opening between the oesophagus and the left bronchus) which affected her quality of life: difficulties swallowing, continuous choking episodes of coughing that repeatedly required hospital admission.
To overcome these after-effects, the medical team resorted to a a device originally designed to treat congenital heart defects in babies: a heart prosthesis Atrial septal defect occluder Amplatzer(R) type. On this occasion, the device was used to close the fistula responsible for the patient's severe discomfort.
Due to the complexity of the case, the procedure required the close and simultaneous collaboration of several specialists, including our Dr. Alberto Herreros de Tejada, head of the Endoscopy Unit at Puerta de Hierro Hospital and a doctor on the GASTEA team.
Dr. Herreros de Tejada explains that this type of intervention, which unites different medical areas, is unusual due to its high complexity and the need for advanced experience. “This procedure involved bringing together several different specialists, something that is not common due to the complexity and the need for high expertise in each area. That's why it's innovative and not used as a first resort. It requires a joint effort that is only justified in exceptional cases,” he points out.
After several previous interventions that failed to close the fistula, the team opted to use this paediatric device, much smaller and suitable for the tiny opening it had to seal.
During the operation, the patient was under general anaesthetic. While the respiratory physician I was introducing a bronchoscope through the airways, Dr. Herreros de Tejada inserted a Gastroscope through the oesophagus to visualise the fistula and guide the intervention. A fine metal guidewire was placed through the fistula which, thanks to coordination with the bronchoscope, was captured to facilitate the correct placement of the Amplatzer® occluder device.
The device was carefully deployed to close the abnormal communication between the oesophagus and the bronchus., real-time control of correct placement with both endoscopes, thereby guaranteeing the successful procedure y avoiding complications.
Thanks to this intervention, the patient was able to resume solid food within a few days and, after two years of suffering, His symptoms practically disappeared in a week. Lilia recalls with emotion: “They put that little badge on me, and, my word, it was like being given heaven. Here I am, healthy as a free pigeon.”.
This case exemplifies Dr. Alberto Herreros de Tejada's ability to integrate advanced knowledge and techniques in endoscopy with other medical specialists, offering innovative solutions for patients with complex problems and significantly improving their quality of life.
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