Novel ASD device closure for treatment of post esophagectomy leak: a case series

Astratt

Abstract Anastomotic leaks occur in 5%–29% of patients after esophagectomy for malignancy and remain a major therapeutic challenge. Conventional options include surgical repair, diversion, endoscopic, or conservative management. A novel approach uses an atrial septal defect (ASD) closure device—originally designed for cardiac use—to seal post-esophagectomy leaks. We report four male patients who developed anastomotic leaks within 14 days after laparoscopic esophagectomy for gastroesophageal junction tumors. Standard management failed, and ASD device placement achieved successful closure in three cases, with long-term follow-up available for two. This series highlights the feasibility, safety, and efficacy of ASD devices as a minimally invasive option for refractory esophageal leaks. Although experience remains limited, these devices show promise as an alternative or adjunct to conventional methods. Further studies comparing outcomes and durability are needed to define their role in gastrointestinal leak management.