Abstract
Aortoesophageal fistula is a rare disease with a high mortality rate. The disease is with high mortality due to aneurysm rupture, and thus successfully managed cases are rarely reported. Here, we report a case of aortoesophageal fistula caused by a huge descending aneurysm and another smaller aneurysm found in the aortic arch. Such case was relatively rare in the cardiovascular field. Due to the limited experience, it was difficult to determine the proper therapeutic strategy. For this case, for the dual aneurysm, we surgically inserted an aortic endovascular stent-graft to exclusive the aneurysm and simultaneously repair the other aortic arch aneurysm. The patient had an uneventful recovery and was discharged after 1 month antibiotics therapy for the palliative treatment of the esophageal fistula. She survived for 8 months at home before dying of massive hematemesis. Here, we present the operative method and our therapeutic experience for this extremely rare case.
Highlights
Aortoesophageal fistula (AEF) with thoracic aneurysms is very rare with poor prognosis, since most patients with AEF die of severe bleeding following aneurysm rupture
The CT angiography (CTA) scan could not be done since severe shock of the patient, so aneurysm and esophageal lesion was not clear, and the reoperation would not be performed with the serious condition and unclear lesion change
AEF was managed with surgical thoracic esophagectomy and esophagogastrostomy to correct the fistula and esophagus
Summary
Aortoesophageal fistula (AEF) with thoracic aneurysms is very rare with poor prognosis, since most patients with AEF die of severe bleeding following aneurysm rupture. 80% of AEFs are caused by thoracic aortic aneurysms, trauma, and malignant esophageal tumors [1]. Most patients with thoracic aortic aneurysms are asymptomatic. The patient promptly underwent surgery that allowed direct access to the descending aorta for stent implantation to isolate the aneurysm and simultaneously repair the aortic arch aneurysm with an artificial graft patch.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
