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1.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33542018

RESUMO

We report a case of chronic Q fever presenting with catastrophic bleeding from an infected abdominal aortic aneurysm causing a primary aortoduodenal fistula in an 80-year-old retired farmer. This presentation is rarely reported in literature and only through case reports. Early diagnosis and definitive surgery were critical to a successful outcome. Serological diagnosis of Q fever was initiated on the patient's past exposure to animal reservoirs. Complicating the case was ongoing gastrointestinal bleeding postsurgery, with multiple endoscopies undertaken before a culprit remnant fistula was found. This case highlights the value in considering Coxiella burnetii as an underlying cause in patients with known risk factors presenting with primary aortoduodenal fistulas. Though rare, it represents a readily treatable cause.


Assuntos
Aneurisma da Aorta Abdominal/complicações , Hemorragia Gastrointestinal/etiologia , Fístula Intestinal/cirurgia , Febre Q/diagnóstico , Fístula Vascular/cirurgia , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Antimaláricos/uso terapêutico , Coxiella burnetii/isolamento & purificação , Doxiciclina/uso terapêutico , Duodenopatias/cirurgia , Humanos , Hidroxicloroquina/uso terapêutico , Masculino , Febre Q/tratamento farmacológico , Tomografia Computadorizada por Raios X
2.
BMJ Case Rep ; 14(2)2021 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-33547124

RESUMO

We report a case of aortoenteric fistula 2 years following endovascular aortic aneurysm repair (EVAR) for mycotic aneurysm presenting as upper gastrointestinal bleeding. Initial CT angiogram did not reveal the bleeding or connection to bowel, but endoscopy was suspicious of endograft in the duodenum. Management required a multidisciplinary approach. To stabilise the patient and to control bleeding, a 'bridging' endograft extension was performed. This was followed by open surgical removal of the EVAR endograft and lower limb in situ revascularisation. During postoperative recovery, the patient developed atypical, staged multisystemic symptoms (cardiac, pulmonary and neurological). With increasing awareness of the COVID-19 pandemic, the patient was found SARS-CoV-2-positive, which explained the progression of his symptoms. This was also reflected on other case reports in literature later.


Assuntos
Aneurisma Infectado/cirurgia , Aneurisma da Aorta Abdominal/cirurgia , Procedimentos Endovasculares/métodos , Fístula Intestinal/complicações , Fístula Vascular/complicações , Idoso , Antibacterianos/uso terapêutico , Aorta/diagnóstico por imagem , Aorta/cirurgia , /terapia , Angiografia por Tomografia Computadorizada/métodos , Pressão Positiva Contínua nas Vias Aéreas/métodos , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Masculino , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
3.
Vasc Endovascular Surg ; 55(1): 95-99, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32875968

RESUMO

Aortoenteric fistula after endovascular aortic repair for an abdominal aortic aneurysm is a rare but severe complication. Particularly, a case of inflammatory abdominal aortic aneurysm is extremely rare and there are only 3 reported cases. A 70-year-old man underwent endovascular aortic repair for impending rupture of an inflammatory abdominal aortic aneurysm and was medicated steroids for approximately 2 years. Four years after endovascular aortic repair, he developed endograft infection with an aortoduodenal fistula and a left psoas abscess. He underwent total endograft excision, debridement, in situ reconstruction of the aorta using prosthetic grafts with omental coverage, and digestive tract reconstruction to prevent leakage. Pseudomonas aeruginosa was detected in the infected aortic sac. The patient has not experienced recurrence of infection in the 35 months since his operation.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/efeitos adversos , Prótese Vascular/efeitos adversos , Duodenopatias/microbiologia , Procedimentos Endovasculares/efeitos adversos , Fístula Intestinal/microbiologia , Infecções Relacionadas à Prótese/microbiologia , Infecções por Pseudomonas/microbiologia , Abscesso do Psoas/microbiologia , Fístula Vascular/microbiologia , Idoso , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Implante de Prótese Vascular/instrumentação , Desbridamento , Remoção de Dispositivo , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Procedimentos Endovasculares/instrumentação , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Masculino , Omento/cirurgia , Infecções Relacionadas à Prótese/diagnóstico por imagem , Infecções Relacionadas à Prótese/cirurgia , Infecções por Pseudomonas/diagnóstico por imagem , Infecções por Pseudomonas/cirurgia , Abscesso do Psoas/diagnóstico por imagem , Abscesso do Psoas/cirurgia , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
4.
Angiol Sosud Khir ; 26(3): 108-114, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33063757

RESUMO

An aorto-oesophageal fistula is a rare but life-threatening pathological condition developing on the background of diseases of the aorta and oesophagus, as well as after surgical interventions on the aorta. The article deals with a clinical case report regarding management of a patient presenting with an aorto-oesophageal fistula resulting from a thoracic artery aneurysm. The main clinical manifestations of the diseases included dysphagia (due to oesophageal obstruction caused by thrombotic masses of the aneurysm) and the occurring gastrointestinal haemorrhage. Comprehensive instrumental diagnosis was performed using roentgen examination of the oesophagus, oesophagoscopy, and contrast-enhanced computed tomography of the chest. The obtained findings made it possible to objectively assess the patient's state, to carry out timely treatment in conditions of a surgical hospital, and to avoid severe complications.


Assuntos
Aneurisma da Aorta Torácica , Doenças da Aorta , Fístula Esofágica , Fístula Vascular , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/diagnóstico , Doenças da Aorta/cirurgia , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Fístula Esofágica/cirurgia , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/cirurgia , Humanos , Fístula Vascular/diagnóstico , Fístula Vascular/etiologia , Fístula Vascular/cirurgia
5.
Pediatr Cardiol ; 41(7): 1346-1353, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32474739

RESUMO

The surgical closure of congenital coronary artery fistulas (CAF) is associated with excellent immediate outcomes. Few studies have investigated the long-term prognosis in patients who have undergone surgery for the closure of CAF or differentiated among types of CAF or types of surgical procedures. In this study, we performed clinical examinations and computed tomography angiography (CTA) to characterize outcomes after CAF closure in pediatric patients. The medical records of 79 pediatric patients who underwent surgical closure of CAF were retrospectively reviewed. The median age of the patients included in the study at the time of surgery was 3.4 years (range 0.2 to 15.3 years). The patients had been followed up for 11 years (range 1 to 17 years) with electrocardiography, echocardiography, and coronary CTA. There were 67 medium-to-large CAF and 12 small CAF. Twenty-six (32.9%) CAF arose from the branch coronary artery (proximal type); the others arose from the parent coronary artery (distal type). The surgical procedure included endocardial closure in 16 cases, epicardial distal ligation in 51 cases, epicardial proximal and distal ligation in 12 cases. There was no instance of perioperative death among the cases included in the study. Twenty-eight patients were treated with antiplatelet medication postoperatively. No patient required re-operation during the follow-up period. Coronary thrombi were detected in 27 patients (34.2%). There was no instance of myocardial ischemia related to thrombosis. Among the patients with thrombosis, 26 had medium-to-large CAF (96.3%), and 23 had distal-type CAF (85.2%). Average age at surgery was higher among the patients with thrombosis than among the patients without thrombosis (7.4 years vs. 3.3 years, t = 5.509, P = 0.000). Among the patients with distal-type CAF, thrombosis was more common among the patients treated with ligation than treated with endocardial closure (41.5% vs. 16.7%, χ2 = 3.742, P = 0.043). There was no difference in risk for thrombosis between the patients who did vs. did not receive antiplatelet therapy (P = 0.436). The most common complication after CAF closure was thrombosis. Increased risk for thrombosis was associated with large fistulae, distal-type CAF, and older age at presentation. Antiplatelet treatment did not appear to decrease the risk of thrombosis. Among patients with distal-type CAF, risk for thrombosis was lower among patients treated with endocardial closure, compared with patients treated with epicardial ligation.


Assuntos
Doença da Artéria Coronariana/cirurgia , Anomalias dos Vasos Coronários/cirurgia , Fístula Vascular/cirurgia , Adolescente , Criança , Pré-Escolar , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/tratamento farmacológico , Trombose Coronária/tratamento farmacológico , Trombose Coronária/etiologia , Anomalias dos Vasos Coronários/complicações , Anomalias dos Vasos Coronários/tratamento farmacológico , Ecocardiografia , Eletrocardiografia , Feminino , Seguimentos , Humanos , Lactente , Masculino , Inibidores da Agregação de Plaquetas/uso terapêutico , Prognóstico , Estudos Retrospectivos , Resultado do Tratamento , Fístula Vascular/complicações , Fístula Vascular/congênito , Fístula Vascular/tratamento farmacológico
6.
J Card Surg ; 35(5): 1152-1155, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32302027
7.
Vasc Endovascular Surg ; 54(5): 445-448, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32295492

RESUMO

Aortoduodenal fistula after endovascular treatment of abdominal aortic aneurysm is a very rare but life-threatening complication. Herein, we describe 4 cases of aortoduodenal fistula diagnosed at 15 to 78 months after the index aortic intervention, all successfully treated by surgery. All patients underwent primary repair of the duodenal wall, creation of tube duodenostomy, stent graft removal, and in situ reconstruction using a rifampicin-soaked prosthesis. Patients received prolonged antibiotic treatment for at least 2 months postoperatively, and all were free of recurrent infection at follow-up. Prompt and appropriate surgical intervention is required to effectively manage this condition.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Doenças da Aorta/etiologia , Implante de Prótese Vascular/efeitos adversos , Duodenopatias/etiologia , Procedimentos Endovasculares/efeitos adversos , Fístula Intestinal/etiologia , Fístula Vascular/etiologia , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Prótese Vascular , Implante de Prótese Vascular/instrumentação , Remoção de Dispositivo , Duodenopatias/diagnóstico por imagem , Duodenopatias/cirurgia , Duodenostomia , Procedimentos Endovasculares/instrumentação , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Masculino , Stents , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
8.
Am J Case Rep ; 21: e922153, 2020 Apr 07.
Artigo em Inglês | MEDLINE | ID: mdl-32253368

RESUMO

BACKGROUND Aortoenteric fistula is a dreadful and uncommon complication after abdominal aortic aneurysm repair. Continuous friction against the intestine and the aortic graft along with local inflammation is thought to be the major cause of aortoenteric fistula formation, although it is unexpected to have fistula formation with a thrombosed aortic graft. CASE REPORT Here, we report a case of an aortoenteric fistula between a thrombosed aortoiliac bypass graft and the duodenum in a 75-year-old male patient who presented with a 2-month history of melena. In this case, the aortoduodenal fistula was repaired with excision of the aortic graft, proximal and distal oversewing of the aorta, omental flap coverage, pyloric exclusion and loop gastrojejunostomy creation. CONCLUSIONS An aortoenteric fistula can form through a thrombosed graft. Since this is not an expected route of fistula formation, there may be a delay in identification.


Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Fístula Intestinal/etiologia , Trombose/etiologia , Fístula Vascular/etiologia , Enxerto Vascular/métodos , Idoso , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Masculino , Melena , Trombose/diagnóstico por imagem , Trombose/cirurgia , Tomografia Computadorizada por Raios X , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
10.
BMC Cardiovasc Disord ; 20(1): 136, 2020 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-32169036

RESUMO

BACKGROUND: Coronary artery fistula (CAF) is an abnormal connection between a coronary artery and either a cardiac chamber or the great vessels. Although most patients are asymptomatic, potential complications such as heart failure, angina pectoris or acute myocardial infarction can be fatal. CASE PRESENTATION: We present here a 62-year-old man diagnosed with giant coronary artery fistula complicated with gross coronary artery aneurysm and acute myocardial infarction. He underwent intravenous thrombolysis treatment at a local hospital, coronary angiography at a regional hospital and complex surgery at a national centre for cardiovascular disease. The patient had no major adverse cardiac events during the 3-year follow-up. CONCLUSION: Early diagnosis of CAF patients and an appropriate treatment plan are the key factors for avoiding serious complications. Because of the rare incidence of this disease, it is necessary to discover and discuss management strategies, including medical management, percutaneous interventions or surgical treatment, for a successful outcome.


Assuntos
Aneurisma Coronário/etiologia , Anomalias dos Vasos Coronários/complicações , Infarto do Miocárdio/etiologia , Fístula Vascular/complicações , Procedimentos Cirúrgicos Cardíacos , Aneurisma Coronário/diagnóstico por imagem , Aneurisma Coronário/cirurgia , Anomalias dos Vasos Coronários/diagnóstico por imagem , Anomalias dos Vasos Coronários/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/tratamento farmacológico , Terapia Trombolítica , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
11.
BMJ Case Rep ; 13(3)2020 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-32139445

RESUMO

Here we present a rare combination of aortobronchial fistula and Listeria endograft infection after repeat endovascular aortic repair. Device retention, debridement and negative pressure wound therapy, in combination with suppressive antimicrobial therapy, led to satisfactory control of infection until the patient died due to another complication. The combination of an aortobronchial fistula and Listeria endograft infection has never been described before. This present case should encourage and show clinicians the importance of an interdisciplinary approach in highly difficult clinical courses.


Assuntos
Aneurisma Aórtico/cirurgia , Prótese Vascular/microbiologia , Procedimentos Endovasculares/efeitos adversos , Listeriose/tratamento farmacológico , Infecções Relacionadas à Prótese/cirurgia , Fístula Vascular/cirurgia , Idoso , Antibacterianos/uso terapêutico , Evolução Fatal , Humanos , Listeria monocytogenes/efeitos dos fármacos , Masculino , Infecções Relacionadas à Prótese/microbiologia , Fístula Vascular/microbiologia
12.
J Cardiothorac Surg ; 15(1): 41, 2020 Feb 24.
Artigo em Inglês | MEDLINE | ID: mdl-32093725

RESUMO

BACKGROUND: Tracheo-innominate artery fistula (TIF) is a rare but fatal complication occurring after tracheotomy. Brachiocephalic trunk transection, one of the surgical treatments for TIF, is mostly associated with a full or partial median sternotomy. We describe a case of TIF with continuous bleeding, which was successfully treated with brachiocephalic trunk transection through a collar incision without the need for median sternotomy. CASE PRESENTATION: Case 1. An 18-year-old man was referred to our hospital with bleeding from a tracheal stoma, which had ceased prior to admission. TIF was suspected after examination. Innominate artery transection was performed through a collar incision. TIF was not revealed when we cut the innominate artery anterior wall open; therefore, we opted for preventive surgical intervention. The post-operative course was uneventful, and the patient was asymptomatic at the 3-year follow-up. Case 2. A 14-year-old male patient was admitted to our hospital with bleeding from a tracheal stoma, and TIF was suspected after examination. There was persistent bleeding when the cuff of the tracheotomy tube was deflated. Brachiocephalic trunk transection was performed through a collar incision using balloon occlusion. The post-operative course was uneventful, and rebleeding has not occurred 2 years later. CONCLUSIONS: Brachiocephalic trunk transection without any median sternotomy may offer the benefits of post-operative infection prevention. In patients with suspected continuous bleeding, using a balloon catheter may be a safe and effective method of treatment.


Assuntos
Oclusão com Balão , Tronco Braquiocefálico/cirurgia , Hemorragia/terapia , Fístula do Sistema Respiratório/cirurgia , Doenças da Traqueia/cirurgia , Fístula Vascular/cirurgia , Adolescente , Hemorragia/etiologia , Humanos , Masculino , Fístula do Sistema Respiratório/complicações , Doenças da Traqueia/complicações , Traqueostomia , Traqueotomia/efeitos adversos , Fístula Vascular/complicações
13.
Ann Thorac Surg ; 110(2): e85-e86, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32035051

RESUMO

A 29-year-old woman underwent esophageal stent placement after developing esophageal stenosis in the setting of tracheoesophageal fistula repair in childhood. The patient developed hemoptysis from an esophageal to aberrant right subclavian artery fistula; this was managed with several staged procedures involving arterial stent placement, carotid-to-subclavian bypass, and aberrant subclavian artery ligation. The patient then underwent pericardial patch repair of her perforated esophagus. This case illustrates the importance of understanding congenital anatomy and frequent associations, such as tracheoesophageal fistula and aberrant right subclavian artery; furthermore, it demonstrates the importance of multidisciplinary care for complex cases.


Assuntos
Anormalidades Cardiovasculares , Fístula Esofágica/complicações , Artéria Subclávia/anormalidades , Fístula Vascular/complicações , Adulto , Fístula Esofágica/cirurgia , Feminino , Humanos , Fístula Vascular/cirurgia
14.
Ann Thorac Surg ; 110(2): e103-e105, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-31991133

RESUMO

Endobronchial stenting is a well-established palliative approach in lung cancer patients with airway obstruction secondary to tumor burden. However endobronchial stenting can be complicated by stent erosion into adjacent vessels. Although most cases of endobronchial stent-related hemoptysis can be treated by stent revision and/or surgical resection, here we present a case managed by endovascular pulmonary arterial stent placement as a last resort option in the management of an iatrogenic bronchovascular fistula in a nonsurgical candidate.


Assuntos
Fístula Brônquica/cirurgia , Complicações Pós-Operatórias/cirurgia , Artéria Pulmonar/cirurgia , Stents , Fístula Vascular/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade
15.
Gen Thorac Cardiovasc Surg ; 68(2): 93-101, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31894503

RESUMO

Aortobronchial fistulas (ABFs) are rare but fatal if left untreated. Hemoptysis is the most common symptom of the patients. ABFs may occur after any thoracic aortic lesions or maneuveurs for these lesions. The treatment of ABF can be surgical or thoracic endovascular aortic repair. Thoracic endovascular aortic repair can be a safe and less invasive procedure for the treatment of ABFs. However, ABFs might occur in much shorter time after thoracic endovascular aortic repair than any other etiologies. The prognoses of patients with ABFs are poor with a high morbidity and mortality. The selection of a suitable endovascular graft and avoidance of postinterventional complications might effectively prevent the occurrence of ABFs.


Assuntos
Aorta Torácica/patologia , Doenças da Aorta/patologia , Fístula Brônquica/patologia , Fístula Vascular/patologia , Idoso , Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Implante de Prótese Vascular , Fístula Brônquica/cirurgia , Procedimentos Endovasculares , Feminino , Hemoptise , Humanos , Masculino , Pessoa de Meia-Idade , Fístula Vascular/cirurgia
16.
Ann Vasc Surg ; 65: 285.e1-285.e5, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31705994

RESUMO

Abernethy malformation is a very rare congenital vascular malformation consisting of diversion of portal blood away from liver, and it is commonly associated with multiple congenital anomalies. Here, we present a case of a male from China with nonspecific abdominal pain associated with an unusual pattern of type II Abernethy malformation, whose was diagnosed with a portosystemic shunt via a giant portal-inferior vena cava fistula (17.22 mm in diameter). The patient underwent a surgical ligation of the portocaval shunt and recovered well. We believe that this is the first case of a type II Abernethy malformation presenting as a portosystemic shunt via the giant portal-inferior vena cava fistula.


Assuntos
Veias Mesentéricas/cirurgia , Veia Porta/cirurgia , Fístula Vascular/cirurgia , Malformações Vasculares/cirurgia , Veia Cava Inferior/cirurgia , Adulto , Humanos , Ligadura , Masculino , Veias Mesentéricas/anormalidades , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/fisiopatologia , Veia Porta/anormalidades , Veia Porta/diagnóstico por imagem , Veia Porta/fisiopatologia , Resultado do Tratamento , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/fisiopatologia , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Veia Cava Inferior/anormalidades , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/fisiopatologia
17.
World J Pediatr Congenit Heart Surg ; 11(1): 120-122, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31755356

RESUMO

We report a case of an infant surviving aortoesophageal fistula secondary to lithium cell battery ingestion. In the setting of a delayed vascular complication, computed tomography and magnetic resonance imaging are essential to establishing the correct diagnosis and surgical management. Management of children after battery ingestion must be guided by a high index of clinical suspicion.


Assuntos
Doenças da Aorta/diagnóstico , Fístula Esofágica/diagnóstico , Corpos Estranhos , Fístula Vascular/diagnóstico , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Diagnóstico Diferencial , Fístula Esofágica/diagnóstico por imagem , Fístula Esofágica/cirurgia , Feminino , Humanos , Lactente , Imagem por Ressonância Magnética , Near Miss , Tomografia Computadorizada por Raios X , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
18.
Ann Thorac Surg ; 109(5): 1611-1613, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31586613

RESUMO

This case demonstrates successful surgical management of a 6-cm-long aortoesophageal fistula from an infected stent graft. A 69-year-old woman with a penetrating descending thoracic aortic ulcer underwent endovascular aortic repair. Two weeks later, she presented with nausea and melena, and she was found to have an infected stent graft on imaging. She underwent a two-stage procedure encompassing aortic arch debranching and extra-anatomic aortic bypass in stage 1, and stent graft resection, primary esophageal repair, intercostal and omental flap, and jejunostomy tube placement in stage 2. She was discharged 1 month later and is doing well 1.5 years after the operation.


Assuntos
Aorta Torácica/cirurgia , Doenças da Aorta/cirurgia , Implante de Prótese Vascular/métodos , Fístula Esofágica/cirurgia , Laparotomia/métodos , Complicações Pós-Operatórias , Fístula Vascular/cirurgia , Idoso , Falso Aneurisma/complicações , Falso Aneurisma/diagnóstico , Aneurisma da Aorta Torácica/diagnóstico , Aneurisma da Aorta Torácica/cirurgia , Doenças da Aorta/diagnóstico , Doenças da Aorta/etiologia , Angiografia por Tomografia Computadorizada , Fístula Esofágica/diagnóstico , Fístula Esofágica/etiologia , Feminino , Humanos , Reoperação , Fístula Vascular/diagnóstico , Fístula Vascular/etiologia
19.
J Card Surg ; 35(1): 239-241, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31638718

RESUMO

We report a case of surgical treatment of a 58-year-old symptomatic patient with large coronary artery fistula, which drained from the left anterior descending artery into the main pulmonary artery (PA), and concomitant large patent foramen ovale. The surgery was performed through a median sternotomy with aortobicaval total cardiopulmonary bypass. The PA was incised. The fistula was identified 5 mm above the anterior leaflet of the pulmonary valve and was closed off using a prolene suture. Afterward, the atrium septum defect was closed with a Dacron patch via the standard right atrium access. There were no postoperative complications.


Assuntos
Doença da Artéria Coronariana/cirurgia , Artéria Pulmonar/cirurgia , Fístula Vascular/cirurgia , Procedimentos Cirúrgicos Cardiovasculares , Feminino , Humanos , Pessoa de Meia-Idade , Resultado do Tratamento
20.
Ann Vasc Surg ; 65: 283.e1-283.e5, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31678123

RESUMO

Primary aorto-appendicular fistulas are extremely rare in clinical practice, and there are only 3 such cases reported in the available literature. The aim of this study is to present the case of a 68-year-old female patient with primary aorto-appendicular fistula accompanied by infected penetrating aortic ulcer (PAU). At the time of her hospital admission, the patient did not demonstrate any typical symptoms. Multidetector computed tomography imaging of aorta was performed during an additional preoperative examination and the PAU of the infrarenal aortic segment was detected. Other pathological changes were not found. The intraoperative findings confirmed the presence of the PAU firmly attached to the appendix and surrounding signs of inflammation. Appendectomy and partial resection of the PAU were performed, along with aortic reconstruction, using a Dacron tube graft and right renal artery reattachment. During the postoperative period, there were no complications, and the patient was discharged on the 10th postoperative day. Control medical examination and color duplex ultrasonography were performed 18 months after the surgery and they provided satisfactory results.


Assuntos
Aorta Abdominal , Doenças da Aorta/complicações , Apêndice , Fístula Intestinal/etiologia , Úlcera/complicações , Fístula Vascular/etiologia , Idoso , Aorta Abdominal/diagnóstico por imagem , Aorta Abdominal/cirurgia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/cirurgia , Apendicectomia , Apêndice/diagnóstico por imagem , Apêndice/cirurgia , Implante de Prótese Vascular , Feminino , Humanos , Fístula Intestinal/diagnóstico por imagem , Fístula Intestinal/cirurgia , Resultado do Tratamento , Úlcera/diagnóstico por imagem , Úlcera/cirurgia , Fístula Vascular/diagnóstico por imagem , Fístula Vascular/cirurgia
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