Complex two-stage open surgical repair of an aortoesophageal fistula after thoracic endovascular aortic repair

Aortoesophageal fistula after thoracic endovascular aortic repair is a rare but fatal complication, and no clear guidelines exist in the literature for optimal management. Herein, we report a complex case of a patient with an infected thoracic endograft that led to an aortoesophageal fistula. The tr...

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Bibliographic Details
Main Authors: Cassius Iyad Ochoa Chaar, MD, MS, RPVI, Mohammad A. Zafar, MD, Camilo Velasquez, MD, Ayman Saeyeldin, MD, John A. Elefteriades, MD, PhD (hon)
Format: Article
Language:English
Published: Elsevier 2019-09-01
Series:Journal of Vascular Surgery Cases and Innovative Techniques
Online Access:http://www.sciencedirect.com/science/article/pii/S2468428719300322
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Summary:Aortoesophageal fistula after thoracic endovascular aortic repair is a rare but fatal complication, and no clear guidelines exist in the literature for optimal management. Herein, we report a complex case of a patient with an infected thoracic endograft that led to an aortoesophageal fistula. The treatment comprised a two-stage open surgical approach—an extra-anatomic aortic bypass in the first stage, followed by explantation of the infected endograft with ligation of the descending thoracic aorta in the second. This approach controls the focus of infection while allowing flow to the aorta distal to the infected endograft, minimizing visceral ischemia time. Keywords: Thoracic endovascular aortic repair (TEVAR), Aorta, Complication, Aortoesophageal fistula, Operative technique
ISSN:2468-4287