Late-onset aortoesophageal fistula after treatment of a chronic type B aortic dissection with a three-step approach

Marco Virgilio Usai, MD; Antje Gottschalk, MD; Thomas Schönefeld, MD; Johannes Frederik Schaefers, MD; Giovanni B. Torsello, MD; Andreas Rukosujew, MD

Journal of Vascular Surgery Cases and Innovative Techniques (Mar 2018)

Late-onset aortoesophageal fistula after treatment of a chronic type B aortic dissection with a three-step approach

Marco Virgilio Usai, MD,
Antje Gottschalk, MD,
Thomas Schönefeld, MD,
Johannes Frederik Schaefers, MD,
Giovanni B. Torsello, MD,
Andreas Rukosujew, MD

Affiliations

Marco Virgilio Usai, MD: Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany; Correspondence: Marco Virgilio Usai, MD, Department of Vascular and Endovascular Surgery, University Hospital Münster, Waldeyerstrasse 30, Muenster, NRW 48149, Germany
Antje Gottschalk, MD: Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany
Thomas Schönefeld, MD: Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany
Johannes Frederik Schaefers, MD: Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany
Giovanni B. Torsello, MD: Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany
Andreas Rukosujew, MD: Division of Cardiac Surgery, Department of Cardiothoracic Surgery, University Hospital Münster, Münster, Germany

Journal volume & issue: Vol. 4, no. 1
pp. 50 – 53

Abstract

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Aortoesophageal fistula is a rare but lethal complication after thoracic endovascular repair for thoracic aortic diseases. Extensive treatment is reserved for patients fit for surgery. Various technical approaches have been described; however, mortality rates are still high. Herein, we report a case of a 76-year-old woman with aortoesophageal fistula treated by a three-step treatment approach, with close collaboration between cardiothoracic and general surgery specialists. The patient required tracheostomy after the first procedure, but this was closed at 15 days. She subsequently recovered and is doing well at 3 months after surgery. Staged treatment aims to shorten operative times, to reduce the risk of anesthesia complications, and to provide the patients the time to recover after each procedure.

Published in Journal of Vascular Surgery Cases and Innovative Techniques

ISSN: 2468-4287 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/journal-of-vascular-surgery-cases-innovations-and-techniques

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