Bronchopleural fistula (BPF) following lung resection and thoracic surgery is associated with high rates of morbidity and mortality. Various methods are available for the closure of BPF and thoracic dead space, including flap procedures and thoracoplasty. While delayed random flaps have been used for the treatment of BPF and closure of thoracic dead space, no previous reports have described the concurrent use of laser-assisted indocyanine green angiography (ICG-A). We report a case of successful BPF closure with a random delayed fasciocutaneous flap using laser-assisted ICG-A guidance for flap delay. In conclusion, this case report describes for the first time the successful management of a post-lobectomy BPF using both a delayed flap technique and assessment under ICG guidance. This management technique should be further studied and standardized for use in other patient cases in hopes of minimizing morbidity and mortality from complex cases of BPFs.

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