• The heart surgery forum · Aug 2011

    Case Reports

    Aortoesophageal fistula secondary to thoracic endovascular aortic repair of a descending aortic aneurysm rupture.

    • Sadan Yavuz, Muhip Kanko, Ercument Ciftci, Hakan Parlar, Huseyin Agirbas, and Turan Berki.
    • Department of Cardiovascular Surgery, Kocaeli University School of Medicine, Kocaeli, Turkey. Sadanyavuz67@yahoo.com.tr
    • Heart Surg Forum. 2011 Aug 1; 14 (4): E249-51.

    PurposeWe present the case of a patient who developed an aortoesophageal fistula (AEF) 4 years after thoracic endovascular aortic repair (TEVAR) of a descending thoracic aortic aneurysm rupture.Case ReportA 60-year-old female patient underwent emergency stent graft placement in December 2006 because of rupture of a distal descending aortic aneurysm. The patient was discharged uneventfully. Four years later, the patient was readmitted because of recurrent hematemesis, weight loss, and malaise. A computed tomography scan and an upper gastrointestinal system (GIS) endoscopy examination revealed an AEF located at the midportion of the esophagus and at the caudal end of the stent graft. An emergency stent graft was re-replaced into the previous graft. The patient died from hemorrhagic shock due to massive GIS bleeding while she was being prepared for secondary major esophageal surgery.ConclusionAEF is a catastrophic complication of TEVAR. Conservative treatment is often associated with fatal results. If possible, these patients should be treated with secondary major surgical procedures.

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