Abstract
BackgroundAortoesophageal fistula (AEF) is a relatively rare condition that is often life-threatening. Secondary AEF is a complication of previous surgery, which can be more critical and challenging than primary AEF. The number of secondary AEF is increasing due to increase in the number of thoracic endovascular aortic repair (TEVAR). Although TEVAR has become a successful alternative surgical strategy for thoracic aortic aneurysms, secondary AEF after TEVAR might be critical than other secondary AEF because of severe adhesion between the esophagus and residual thoracic aortic wall.MethodsThis study analyzed six patients with secondary AEF who were treated at Tokyo Medical University Hospital between 2011 and 2016. These participants included four patients who had undergone TEVAR and two who had undergone total arch replacement.ResultsAlthough they were subsequently hospitalized for a long period, open surgical repair was completed in two patients who had undergone total arch replacement. TEVAR alone was performed in two patients who had undergone TEVAR and they were discharged without major complications shortly. Combined repair of TEVAR as a bridge to open surgery was planned for two patients who had undergone TEVAR. However, reconstruction of the aorta and esophagus could not be completed in these patients due to severe adhesions, and they died during hospitalization.ConclusionsDefinitive open repair was successfully performed in patients with secondary AEF after total arch replacement. However, in the patients with secondary AEF after TEVAR, severe adhesion between the aorta and esophagus led to difficulty in performing a successful definitive open repair. The strategy for secondary AEF should, therefore, be decided considering the etiology of secondary AEF. In secondary AEF after TEVAR, definitive open repair is difficult to complete because of catastrophic complication, and palliative treatment using TEVAR without reconstruction of aorta and esophagus can be an alternative.
Highlights
Aortoesophageal fistula (AEF) is a relatively rare condition that is often life-threatening
We retrospectively reviewed the clinical charts of six patients who required surgical intervention for the treatment of secondary AEF at Tokyo Medical University Hospital between 2011 and 2016
Primary AEF resulting from esophageal malignancy, thoracic aortic aneurysm, Sugiyama et al Journal of Cardiothoracic Surgery (2020) 15:251 foreign body ingestion, prolonged gastric tube intubation and etc. was excluded
Summary
Aortoesophageal fistula (AEF) is a relatively rare condition that is often life-threatening. Secondary AEF is a complication of previous surgery, which can be more critical and challenging than primary AEF. The number of secondary AEF is increasing due to increase in the number of thoracic endovascular aortic repair (TEVAR). TEVAR has become a successful alternative surgical strategy for thoracic aortic aneurysms, secondary AEF after TEVA R might be critical than other secondary AEF because of severe adhesion between the esophagus and residual thoracic aortic wall. Aortoesophageal fistula (AEF) is a relatively rare condition that is often life-threatening [1,2,3]. Secondary AEF, a complication of surgery in the posterior mediastinum can be more critical than primary AEF because of the presence of adhesion in the pleural space and the poor general status of patients.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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.
