Aortoesophageal fistula treated using one-stage total reconstruction: a case report from a high-volume center.
J Cardiothorac Surg
; 18(1): 329, 2023 Nov 14.
Article
em En
| MEDLINE
| ID: mdl-37964318
ABSTRACT
BACKGROUND:
Aortoesophageal fistula (AEF) is a rare but typically life-threatening condition. Although several treatment strategies exist, including conservative treatment with intraluminal stent graft and open thoracic aortic replacement, the overall outcome remains poor, ranging from 16 to 39%. Furthermore, esophageal reconstruction methods vary between hospitals. Herein, we report a case of aortoesophageal fistula treated using one-stage total reconstruction. CASE PRESENTATION This case involved a 58-year-old woman who developed acute type A aortic dissection and underwent successful total arch replacement at the other hospital. However, she developed AEF 1 year later and underwent urgent thoracic endovascular aortic repair, which eventually failed. We performed thoracic aortic replacement, total esophagectomy, gastric tube reconstruction, and omental flap in a one-stage operation. The patient was extubated the next day and transferred to the general ward on postoperative day 3. Computed tomography revealed favorable results.CONCLUSIONS:
For postoperative AEF, dedicated debridement with reconstruction is more effective than conservative treatment. In an experienced center, post-procedure-related AEF can be easily treated using one-stage reconstruction.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Doenças da Aorta
/
Fístula Vascular
/
Fístula Esofágica
/
Implante de Prótese Vascular
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article