Open Repair without Esophagectomy for an Aortoesophageal Fistula after Thoracic Stent Grafting
- VernacularTitle:TEVAR 後の胸部大動脈瘤食道瘻に対する食道温存下行大動脈置換術の1例
- Author:
Takashi OGASAWARA
1
;
Kazuyuki DAITOKU
1
;
Anan NOMURA
1
;
Tomonori KAWAMURA
1
;
Satoshi TANIGUCHI
1
;
Ikuo FUKUDA
1
Author Information
- Keywords: aortoesophageal fistula; infected thoracic aortic aneurysm; omental flap
- From:Japanese Journal of Cardiovascular Surgery 2019;48(5):345-350
- CountryJapan
- Language:Japanese
- Abstract: An aortoesophageal fistula is a critical condition with high operative mortality. A case of aortoesophageal fistula following thoracic endovascular aneurysm repair is reported. The patient was a 72-year-old man complaining of dysphagia who underwent stent grafting for a saccular aneurysm of the descending aorta that was compressing the esophagus four months earlier. Endoscopic examination showed perforation of the aneurysm into the esophagus with severe stenosis. The aneurysmal sac was filled with thrombus. Aortography demonstrated a type I endoleak from the lesser curvature of the aortic arch, draining into the aneurysmal sac. The patient was afebrile with moderate elevation of C-reactive protein, and the white blood cell count was normal. The patient underwent closure of the aneurysmal entry with healthy aortic wall and replacement of the descending aortic aneurysm with a prosthetic graft. The graft was isolated from the fistula by an omental flap. The patient's postoperative course was uneventful. Computed tomography performed 4 years after the surgery showed shrinkage of the aneurysmal sac. The patient has had a healthy life for 9 years since the operation.
