Definitive Endovascular Treatment Of Aortoesophageal Fistula In A Young Patient
Sun Kyun Ro, Soohwan Choi.
Department of Thoracic and Cardiovascular Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, Korea, Republic of.
BACKGROUND: An aortoesophageal fistula (AEF) is a rare and highly fatal disease, which could lead to high operative morbidity and mortality. Although several treatment options for AEF have been introduced, evidence-based guidelines could not be established due to the rarity of the disease. Here, we report a case of successful endovascular treatment with subsequent esophageal surgery for AEF. METHODS: A 27-year-old female with complaints of abrupt hematemesis visited our emergency department. She was presented with hypovolemic shock and was diagnosed as having an AEF with an outpouching aneurysm at the descending thoracic aorta.
RESULTS: Emergent zone 3 TEVAR was performed under local anesthesia. Primary repair of the ruptured esophagus with evacuation of the hematoma was performed 8 days after TEVAR. She was discharged without any evidence of acute complication and has been uneventfully followed up for 36 months.
CONCLUSIONS: Leaving the implanted thoracic stent graft in place could be considered if the clinical evidence suggests a resolution of the related infection. Life-long follow-up should be conducted for patients who underwent definitive TEVAR for AEF.
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