Challenges and complications of using EZ™ bronchial blocker in minimally invasive coronary artery bypass grafting surgery: A case series

We present a case series of challenges and complications of using Rusch EZ blocker™ (Teleflex Life Sciences Ltd., Athlone, Ireland), a specially designed semi rigid Y shaped bronchial blocker containing two inflatable cuffs. We describe fifteen different patients (out of eighty four attempted EZ blockers) undergoing MICS CABG, in whom we faced different technical difficulties and adverse effects while using EZ blocker. We report failed EZ blocker insertion due to anatomical reasons, misplaced blocker following insertion and also few manufacturer defects. We have also encountered hemodynamic instability and bronchial injury in small percentage of cases. The EZ blocker is an easy, safe and reliable device for lung isolation but clinicians must know, prevent and solve the unexpected associated troubles which can happen acutely during insertion or insidiously post endobronchial placement.