Figure 1.

A, Abdominal CT scan confirming the persistent esophagopleural fistula (yellow arrow), an adequately placed stent (red arrow), and a right pleural effusion (arrowhead).B, Esophagram showing contrast medium leaking into the right pleural space (yellow arrow).C, Upper endoscopy revealing a 5-mm fistulous opening in the proximal esophagus (blue arrow).D, Side view of the chest wall demonstrating the thoracostomy window, and the subtle fistulous opening (yellow arrow).E, Scheme of the atrial septal occluder device that was deployed under endoscopic guidance. Copyright 2012 by W.L. Gore & Associates, Inc. Reprinted by permission of W.L. Gore & Associates, Inc. F, Endoscopic view of the esophagus, showing the proximal end of the deployed atrial occluder device covering the fistulous opening. G, Side view of the chest wall showing the deployed atrial septal occluder covering the fistulous defect. H, 4-week follow-up CT scan of the abdomen, showing device and closed defect (green arrow).I, Side view of the chest wall demonstrating the septal occluder covered by fibrous connective tissue (yellow arrow).