Spontaneous Closure Research Articles

Clinical and diagnostic value of the novel algorithm for categorisation of neonatal interatrial communication; findings at follow-up in preschool children

Abstract Background and aim Differentiation between a patent foramen ovale (PFO) and an atrial septal defect (ASD) of the secundum type is challenging, particularly in newborns. A PFO is considered normal, often undergoes spontaneous closure and is rarely associated with complications. An ASDs on the other hand tend to remain patent and may lead to right sided volumen overload, atrial fibrillation, and stroke, often necessitating surgical repair. To determine the need for follow-up in newborns with interatrial communications (IACs), a clear diagnostic differentiation between ASD and PFO is essential. We recently developed an algorithm to facilitate differentation between ASD and PFO in newborns. In this study, we reassessed preschool children diagnosed according to this algorithm with an ASD or a PFO neonatally, to investigate potential differences in patentcy between the two IAC subtypes. Methods Children participating in a large, multicenter, prospective population study were enrolled for a follow-up echocardiogram if they had a PFO or an ASD detected at the neonatal echocardiogram. The recently developed algorithm classifies IACs into three subtypes of PFO and three subtypes of ASD. According to the algorithm an ASD was defined as a defect with a diameter ≥4 mm, a location in the inferior part of the septum, or if multiple communications were present. Children with neonatal IACs were included until reaching n=200 in each of the six groups of IAC subtypes, or all children in a group (n<200) were invited. A single operator, blinded to the neonatal IAC subtype, assessed the follow-up echocardiograms for patency of an IAC. Patent IACs were reclassified as ASD or PFO using the same algorithm. Results We included 904 children with IAC (median age 5.2 years [interquartile range 4.5-5.5], 54% female). Neonatally, ASDs were present in 292 newborns and PFOs in 612 newborns. The follow-up echocardiograms showed patency of the IAC in 62 of the children with a neonatal ASD (18.5%) and in 54 of the children with a neonatal PFO (10.1%), (OR 2.0 [95% CI 1.3;3.0], p-value<0.001). Overall, patency was sligtly more frequent in girls (15.1%) compared to boys (10.1%), (OR 1.6 [95% CI 1.0;2.4], p-value<0.05). The risk of having a patent IAC, that classified as an ASD at follow-up, was 7.5% in the group of children with a neonatal ASD, compared to 1.1% in the group with a neonatal PFO, (OR 7.0 [95% CI 2.9;19.7], p-value<0.0001), figure. Conclusions Newborns diagnosed according to the new IAC algorithm with an ASD were twice as likely to have a patent IAC at follow-up at five years of age compared to children diagnosed with a neonatal PFO. At follow-up, the risk of having a patent IAC, that was classified as an ASD, was very low for children with a neonatal PFO. These findings support the diagnostic and clinical value of the new IAC diagnostic algorithm to differentiate between neonates with IACs that may need follow-up.

Spontaneous space closure after extraction of young first permanent molar. Retrospective cohort study.

Early compromised first-permanent-molar (FPM) extraction can adversely affect occlusion. However, the current literature does not provide sufficient support for definitive early extraction outcome. This cohort study aimed to evaluate the pattern of post-FPM extraction spontaneous space closure and its pre-extraction indicators. Patients of 7-13 years, with compromised FPM at three-tertiary-centers between 2015 and 2019 were retrospectively screened. Pre-extraction indicators were evaluated (extraction location, direction of the second permanent molar (SPM) long-axis, and SPM Demirjian development stage). Spontaneous space closure pattern was evaluated clinically and radiographically using the American Board of Orthodontics (ABO) grading system. In total, 112 FPMs (73-patients) were identified and five (4.5%) of the extraction sites showed favorable combined-ABO-scores. Distal direction of the SPM long-axis in the maxillary arch significantly decreased the relative risk (RR) of having a SPM rotation/alignment ABO score-1 (P = 0.002; RR = 0.64). For the mandibular arch, Demirjian stage D and E significantly decreased the RR of having ABO score-1 for spacing between the SPMs and second premolars (P = 0.029; RR:0.57, P = 0.004; RR:0.53, respectively) and vertical dimension (P = 0.02; RR = 0.53). The direction of the SPM long-axis and its developmental stage are key indicators of the favorable outcome pattern of spontaneous space closure after FPM early extraction.

Outcomes of fenestration versus none in extracardiac total cavopulmonary connection.

Fenestrated total cavopulmonary connection has gained popularity due to its capacity to reduce systemic venous pressure and enhance cardiac output. However, there is ongoing debate about the immediate and long-term advantages of fenestration in this context. A retrospective cohort study was conducted involving 97 patients who underwent extracardiac total cavopulmonary connection at Chiang Mai University Hospital between January 1999 and December 2019. The patients were initially categorized into two groups: fenestrated (n = 71) and nonfenestrated (n = 26). After exclusion and reassignment, the long-term outcomes were analyzed for the fenestrated (n = 68) and nonfenestrated (n = 25) groups. To address potential confounding factors between the two groups, propensity scores were computed using logistic regression analysis. The study found no significant differences in preoperative and operative data. Immediate postoperative outcomes showed no significant variations in major complications, intensive care unit stay, oxygen saturation, and posttotal cavopulmonary connection pressure. In the long-term assessment, the fenestrated group demonstrated significantly lower rates of mortality, protein-losing enteropathy, liver mass, and cirrhosis. However, after employing a multilevel model stratified by propensity score analysis, only long-term mortality rate was significantly lower in the fenestrated group (hazard ratio = 0.12, 95% confidence interval = 0.02-0.97). Fenestration patency closed gradually through spontaneous closure and device intervention. The study found no major differences in immediate postoperative outcomes. In the fenestrated cohort, significantly lower incidences of protein-losing enteropathy, liver mass, cirrhosis, and long-term mortality were observed. However, multilevel model stratified by propensity score analysis indicated that only the lower long-term mortality demonstrated a major effect.

A Case of Spontaneous Closure of Recurring Chronic Full Thickness Macular Hole

Purpose: To report a case of spontaneous closure of a chronic recurrent full-thickness macular hole (FTMH) in a previously vitrectomized eye.Case summary: A 58-year-old female who underwent vitrectomy for the treatment of a rhegmatogenous retinal detachment (RRD) on the right eye 2 years ago complaint of decreased vision on the same eye. The best corrected visual acuity (BCVA) was 0.2. The fundus photograph and optical coherence tomography revealed a FTMH with perifoveal cystoid macular edema (CME). While surgical treatment for the macular hole (MH) was scheduled, the spontaneous closure of MH was observed with resolution of CME. BCVA improved to 0.5. During the long-term follow-up periods, FTMH with CME recurred 2 times or more. In all events, the hole was spontaneously closed in 1 month, accompanied with resolution of CME.Conclusions: A FTMH with CME developed 3 times for 11 years following RRD repair, which was spontaneously closed with CME resolution in a month. In case of chronic recurrent FTMH in vitrectomized eye, it would be better to determine surgical treatment after closely monitoring changes in hole and CME.

Spontaneous space closure after extraction of permanent first molars in children and adolescents: a systematic review and meta-analysis.

Extraction of the permanent first molars is sometimes necessitated in children and adolescents due to deep carious lesions or developmental defects. To estimate the prevalence of spontaneous space closure after extraction of permanent first molars and identify factors associated with it. Unrestricted searches in five databases for human studies until February 2024. Longitudinal before-and-after (cohort) human studies assessing eruption of the permanent second molars and spontaneous space closure after extraction of the permanent first molar. Study selection, data extraction, and risk of bias assessment were performed in duplicate. Random-effects meta-analyses of average spontaneous space closure prevalences and odds ratios (OR) with their 95% confidence intervals (CI) were performed, followed by meta-regression/sensitivity/reporting biases' analyses and evaluation of our confidence in effect estimates. Sixteen reports pertaining to 15 studies (1 prospective /14 retrospective) were included covering 1159 patients (ages 5.5-15.0 years [mean 10.0 years]; 45% male on average) and 2310 permanent second molars. The prevalence of spontaneous space closure was higher in the maxilla (nine studies; 85.3%; 95% CI = 73.7%-92.3%) than the mandible (11 studies; 48.1%; 95% CI = 34.5%-62.0%) to a significant extent (nine studies; OR = 7.77; 95% CI = 4.99-12.11; P < 0.001). For both maxillary/mandibular second molars, Demirjian category E was associated with increased space closure odds than earlier/later stages (P < 0.05). Spontaneous space closure in the mandible was seen more often for patients ages 8-10 years (compared with older patients; three studies; OR = 3.32; 95% CI = 1.73-6.36; P < 0.001) and when the mandibular permanent third molar was present (four studies; OR = 2.28; 95% CI = 1.67-3.09; P = 0.003). Additional analyses failed to find any significant modifying factors. The quality of evidence was very low in all instances due to the inclusion of retrospective studies with methodological issues. Existing evidence indicates that spontaneous space closure in children and adolescents after extraction of the permanent first molar is seen more often in the maxilla than the mandible. Extraction of the permanent first molar at the Demirjian stage E of the second molar and presence of the lower permanent third molar is associated with increased odds of space closure, but uncertainty persists, due to methodological issues of existing studies. PROSPERO (CRD42023395371).

The role of vitreous cortex remnants in secondary macular hole formation and spontaneous closure following vitrectomy for rhegmatogenous retinal detachment

BackgroundMacular hole (MH) formation after rhegmatogenous retinal detachment (RRD) surgery is rare, and in most cases, additional surgical procedures are required to repair MH. Spontaneous closure of the MH is even rarer. In this study, we aimed to report a series of cases of spontaneous closure of the secondary MH and provide a review of the literature. MethodsWe retrospectively collected the cases of secondary MH formation following vitrectomy in RRD patients followed by spontaneous closure. Ophthalmological data at presentation and during follow-up were collected and analyzed. ResultsWe reported a total of three RRD patients aged 31,67,12 years, including two females and one male. The three patients underwent pars plana vitrectomy (PPV) with either silicone oil tamponade or air tamponade. Optical coherence tomography (OCT) revealed a second full-thickness MH formation with remnant vitreous cortex bridging in the macular region during early follow-up. Observations of the cases revealed subsequent remnant vitreous cortex traction remission and spontaneous closure of MH during follow-up, although with subsequent thin macular and abnormal macular structure. ConclusionThe progression of secondary MH formation in the cases may be related to vitreomacular traction (VMT) by the posterior vitreous cortex remnant after PPV, and the release of VMT may help the spontaneous closure of the MH after PPV for RRD.

Factors related to spontaneous space closure following early first permanent molar extraction: A systematic review.

Dental caries and molar-incisor hypomineralization (MIH) are primary reasons for the extraction of first permanent molars (M1) in children, which can lead to significant dental and facial development issues such as a midline shift and temporomandibular joint disorder. This systematic review aimed to identify key factors influencing spontaneous space closure following the early extraction of first permanent molars (M1) in children aged 5-15. We conducted a comprehensive search across Scopus, PubMed, Dimensions, Web of Science, and Cochrane databases, including the literature from 1960 to 2024. The inclusion criteria focused on clinical trials, case-control, cross-sectional, cohort studies, and case series that evaluated the impact of various factors on the spontaneous closure after M1 extraction. The analysis highlights that chronological age and the developmental stage of the second permanent molars (M2) at the time of extraction are significant predictors of successful spontaneous space closure. Additionally, the presence and angle of M2, along with the presence of third permanent molars (M3), play crucial roles but require further investigation. Early assessment of M2's developmental stage and inclination, and the presence of M3 are essential for enhancing the likelihood of successful spontaneous space closure following M1 extraction in children.

Resolution of Macular Confluent Drusen During the Development and Spontaneous Closure of an Eccentric Full-Thickness Macular Hole.

To describe a unique case of drusen resolution accompanying the spontaneous closure of an eccentric full-thickness macular hole (FTMH). This study is a case report. A 71-year-old male exhibited confluent drusen in the right eye beneath the fovea. During regular follow-up, an eccentric FTMH developed in the right eye and closed spontaneously. Concurrently, the confluent drusen showed rapid regression without signs of geographic atrophy or macular neovascularization. Visual acuity remained stable throughout the monitoring period. This case suggests that drusen regression can occur alongside spontaneous FTMH closure without surgical intervention. This adds to the current understanding of the pathology and treatment for drusen.

A population-based study of incidence, aetiology, treatment and outcome of enterocutaneous fistula.

The aim of this work was to investigate the incidence of enterocutaneous fistula (ECF), including both small bowel and colonic fistulas, in a defined population of 1.04 million during a 10-year period and to describe aetiology, treatments, care consumption and outcome. A comprehensive search algorithm including diagnostic and procedural codes, enterostomal therapy nurse notes and in-hospital care for >60 days yielded 1970 search hits. After reviewing medical records, 187 patients with ECF were identified. The annual incidence of ECF was 2.3 per 100 000, the incidence of ECF with intestinal failure type II was 0.9 per 100 000. Spontaneous closure of the fistula occurred in 16.0% of patients, while closure was seen in 97.3% of patients who underwent reconstructive surgery with recurrences in 6.7% and 8.3%, respectively. Cumulative ECF-related in-hospital care until closure or end of follow-up was 4 (range 0-61) weeks. Eighty-eight patients (47%) received home-based healthcare including parenteral feeding and/or fistula wound care. The estimated overall mortality at 1, 3 and 5 years was 33.7%, 42.1% and 47.6% respectively. Mortality was mainly in patients without spontaneous closure or reconstructive surgery, and the risk of ECF-related death was 30.2%. This study defines the population-based incidence of ECF and reports a high overall mortality rate. Initial survivors were characterized by either spontaneous closure or eligibility for later reconstructive surgery, but with an eventual mortality rate of approximately 20%. ECF patients are high consumers of care: 55.1% needed ≥4 weeks in hospital and many received home-based healthcare.

Iatrogenic atrial septal defects in structural heart interventions: Opening the Pandora's box

AbstractIn the modern era of structural heart interventions, the total number of transseptal procedures is growing exponentially, thus increasing the rate and need for management of iatrogenic atrial septal defects (iASDs). To date, there are no official guidelines on the assessment and management of iASDs, due to inconclusive evidence on whether patients benefit more from the percutaneous closure of iASD than from conservative management and vigorous follow‐up. Despite the abundance of observational studies on iASDs, there is still a lack of randomized studies. Evidence so far show that percutaneous closure is no superior over conservative treatment in patients with iASDs, however, it has been demonstrated that patients with spontaneous closure of iASDs experience less heart failure (HF) hospitalizations. On the other hand, researchers have investigated the beneficial nature of interatrial shunt therapy in patients with HFpEF and, more recently, with HFrEF, due to the presumed hemodynamic benefits. Herein, we provide an updated review of relevant literature, focusing on iASD persistence rates, predicting factors for their persistence, and clinical outcomes of iASD persistence, to summarize available evidence and discuss future directions in the field.

Factors Predicting Spontaneous Closure of Patent Ductus Arteriosus in Very Low Birth Weight Neonates.

Background Patent ductus arteriosus (PDA) is a relatively rare condition among neonates in the United States, estimated at approximately 1 in every 2,000 births. Managing hemodynamically significant patent ductus arteriosus (hsPDA) in very low birth weight (VLBW) neonates remains a challenge. This study aims to explore and report on the spontaneous closure of hsPDA in VLBW infants in a clinical setting. Methods We conducted a retrospective review of VLBW infants born from 2006 to 2014 at our institution. Infants included in the study were diagnosed with hsPDA via echocardiogram in the first week of life. We divided our population into two study groups: 1) those with PDA closure before discharge without medical/surgical treatment (spontaneous closure) and 2) those with closure by medical/surgical treatment. Relevant baseline data and PDA-related parameters were extracted from the medical records. Results A total of 108 infants were included in the study; 52 experienced spontaneous PDA closure, and 56 required treatment. Of the baseline characteristics, gestational age and mode of delivery differed significantly between the two groups. Within the adjusted model, cesarean section (CS) (OR: 0.18; 95% CI: 0.06-0.55), average pre-diagnosis partial pressure of carbon dioxide (PCO2) (OR: 0.92; 95% CI: 0.86-0.98), and pre-diagnosis daily fluid intake (OR: 0.96; 95% CI: 0.94-0.99) were associated with increased odds of spontaneous closure. Conclusion In our study of VLBW infants, several variables were associated with spontaneous hsPDA closure. Studies with larger sample sizes are much needed and have the potential to clinically impact the outcomes of neonates living with this relatively rare condition.

Intracardiac ultrasound-guided transseptal puncture in horses: Outcome, follow-up, and perioperative anticoagulant treatment.

Cardiac catheterizations in horses are mainly performed in the right heart, as access to the left heart traditionally requires an arterial approach. Transseptal puncture (TSP) has been adapted for horses but data on follow-up and closure of the iatrogenic atrial septal defect (iASD) are lacking. To perform TSP and assess postoperative complications and iASD closure over a minimum of 4 weeks. Eleven healthy adult horses. Transseptal puncture was performed under general anesthesia. Serum cardiac troponin I concentrations were measured before and after puncture. Weekly, iASD closure was monitored using transthoracic and intracardiac echocardiography. Relationship between activated clotting time and anti-factor Xa activity during postoperative enoxaparin treatment was assessed in vitro and in vivo. Transseptal puncture was successfully achieved in all horses within a median duration of 22 (range, 10-104) minutes. Balloon dilatation of the puncture site for sheath advancement was needed in 4 horses. Atrial arrhythmias occurred in 9/11 horses, including atrial premature depolarizations (N = 1), atrial tachycardia (N = 5), and fibrillation (N = 3). Serum cardiac troponin I concentrations increased after TSP, but remained under the reference value in 10/11 horses. Median time to iASD closure was 14 (1-35) days. Activated clotting time correlated with anti-factor Xa activity in vitro but not in vivo. Transseptal puncture was successfully performed in all horses. The technique was safe and spontaneous iASD closure occurred in all horses. Clinical application of TSP will allow characterization and treatment of left-sided arrhythmias in horses.

Feasibility and Acceptability of a Prospective Syphilis Sexual Network Study for Sexual Minority Men.

In preparation for a prospective syphilis network study of sexual minority men, we conducted a mixed-methods formative study with the following objectives: a) assess acceptability of respondent driven sampling (RDS), b) assess acceptability of study procedures, c) social network seed selection, and d) pilot an ecological momentary assessment (EMA) study to assess social networking, sexual and substance use behavior. We conducted in-depth interviews with eight providers serving sexual minority men and five focus group discussions with 34 sexual minority men, prioritizing four target populations: young Black sexual minority men, 2) on PrEP, 3) living with HIV, 4) not engaged in care. The 4-week EMA pilot was conducted with 40 sexual minority men. EMA survey responses were analyzed to evaluate how different compensation levels influenced response rates. Brief exit surveys were used to assess EMA app acceptability. Primary themes identified through qualitative data collection: 1) importance of developing trust and maintaining confidentiality during proposed recruitment activities, 2) importance of compensating participants appropriately for study activities, and 3) cultural considerations for increasing visibility and participation of young Black sexual minority men. All EMA participants reported being "completely comfortable" reporting sexual behavior through the app. Most (78%) preferred the app to in-person interviews. Several participants identified technical issues with the app, including not receiving push notifications and spontaneous closure. This mixed-methods formative study allowed for adjustments to and tailoring of the planned network study, including recruitment protocols, compensation type and amount, and EMA survey wording and response items.

Single Center Retrospective Evaluation of Coronary Artery Fistula Outcomes.

There is a paucity of literature describing long-term outcomes of patients with coronary artery fistula with most manuscripts focusing on those requiring interventions. We describe single-center outcomes of coronary artery fistulas including those not requiring intervention. We performed a retrospective review of the electronic medical record and identified all patients with a diagnosis of coronary artery fistula over the last 10years. 158 patients were identified with a coronary artery fistula. The mean age at diagnosis was 5.8years (SD ± 5.9). There was a male (55%, n = 87) predominance. Concomitant congenital heart lesion was present in 49% (n = 77) and a genetic anomaly was found in 18% (n = 29). No ischemic changes on electrocardiogram or ECG-stress test were observed. The mean follow-up was 5.0 (SD ± 3.8) years. Most patients (94%, n = 149) did not undergo an intervention. Of those 63% (n = 94) had at least one follow-up echocardiogram. There was spontaneous coronary artery fistula closure in 44% (n = 41), 8% (n = 8) decreased in size, and 48% (n = 45) were unchanged. No patient had enlargement of the coronary artery fistula over time. Additionally, tiny and small coronary artery fistulas showed no significant clinical changes in coronary artery dimensions, left ventricle dimensions and function over time. Seven patients required intervention; two patients underwent surgical ligation and five underwent catheter-based intervention. Most patients with coronary artery fistula in our cohort did not require intervention and over half either closed spontaneously or decreased in size with routine follow-up.

Evaluation of intracardial hemodynamics in children under 1 year of age with atrial septal defect

Aim: evaluation of the intracardiac hemodynamics and determination indications for early correction of the atrial septal defect in children before 1 year age.Methods. The study included patients observed from 2010 to 2021. The first group was formed from children under the age of 12 months with ASD and were observed for the next 4 years until its interventional or surgical elimination. The second group included healthy children of the appropriate age. All patients underwent an echocardiographic (ECHO) study with assessment of the main parameters of hemodynamics and intracardial structures.Results. The first group included 887 children with ASD, the control group included 887 healthy children. The age of the patients included in the study was 6 ± 2.6 months. for group I and 6 ± 2.5 months. for the second one. It was found that in young children with ASD, the first manifestation of hemodynamic changes was dilatation of the right ventricle, then the right atrium and finally dilatation of the pulmonary trunk, which was accompanied by an increase in pressure in the pulmonary circulation and weight loss. In 11% of patients, spontaneous closure of the ASD occurs within the first year of life. Almost 20% of patients are younger than 6 months. have clinical and hemodynamic indications for surgical treatment of ASD.Conclusions. Indications for the atrial septal defect closure should be determined taking into account clinical, anatomical and hemodynamic parameters.

Rare spontaneous closure of coronary artery to right atrium fistula detected by coronary computed tomography angiography.

Rare spontaneous closure of coronary artery to right atrium fistula detected by coronary computed tomography angiography.

Autologous-Fibrin Induction: A Novel Approach for Sutureless Sclerotomy Closure in Pars Plana Vitrectomy

Purpose This study presents a novel sutureless closure approach for sclerotomies following pars plana vitrectomy (PPV) and assesses its efficacy and safety. Methods A total of 142 eyes were included in the study. PPV procedures were performed using 23-gauge (23 G) or 25-gauge (25 G) systems. Preoperative characteristics, intraoperative findings, and postoperative outcomes were documented. Results The cohort included 80 males and 62 females (mean age: 60.4 ± 12 years), primarily undergoing surgery for retinal detachment (59%). Among the patients, 87% underwent 25 G PPV (35% three-port, 52% four-port), while 13% underwent 23 G PPV (12% three-port, 1% four-port). Gas tamponade was administered in all cases, with perfluoropropane used in 45.7% of instances, sulfur hexafluoride in 29.5%, and air in 24.6%. Spontaneous closure was observed in 9.4% (47 of 501) of sclerotomies, autologous-fibrin induction approach successfully closed 75.8% (380 of 501) of the sclerotomies (83.7% of leaking sclerotomies) and 14.7% (74 of 501) of sclerotomies needed sutures. Visual acuity improved postoperatively, and first-day hypotony rate was 6.3%. Importantly, no serious complications such as choroidal detachment or endophthalmitis were observed during the postoperative period. Conclusion The autologous-fibrin induction offers a simple, cost-efficient, and reliable approach for sutureless sclerotomy closure in PPV, with promising outcomes.

Full-thickness macular hole recurrence after spontaneous closure

A 47-year-old female presented with reduced left visual acuity of 6/18 and metamorphopsia. She was found to have a full-thickness central macular hole (Figure 1A). Surgical repair was planned, however one week prior to scheduled surgery the hole had spontaneously closed (Figure 1B).

Spontaneous Closure of a Full-Thickness Macular Hole

Spontaneous Closure of a Full-Thickness Macular Hole

Surgical repair of an aortoesophageal fistula after salvage thoracic endovascular aortic repair: a case report

BackgroundAn aortoesophageal fistula can prove to be fatal. Salvage thoracic endovascular aortic repair as a bridging therapy and radical surgery with thoracotomy should be considered while treating aortoesophageal fistula without spontaneous closure. Moreover, it is essential to select a technique that reduces the risk of reinfection. Here we report a rare case of a ruptured thoracic aortic aneurysm related to esophageal perforation by a fish bone that led to massive hematemesis and shock, and the surgical treatment of an aortoesophageal fistula that developed after salvage thoracic endovascular aortic repair.Case presentationA 70-year-old Japanese female patient was admitted with hematemesis, thoracic pain, and shock related to esophageal perforation of a ruptured descending aortic aneurysm caused by fish bone aspiration and esophageal perforation 1 month previously. An emergency thoracic endovascular aortic repair was performed. Postoperatively, an aortoesophageal fistula that remained open and a food intake-related increase in the inflammatory response was noted. Radical blood-vessel prosthesis implantation and fistula closure were performed. The patient’s postoperative course was favorable and the patient was discharged 22 days after the blood vessel prosthesis implantation.ConclusionSuch a case of rupture of a descending aortic aneurysm related to perforation by a fish bone and an aortoesophageal fistula is considerably rare. Thus, we report the therapeutic strategy of this particular case and review the relevant literature.