Aortoesophageal fistula following TEVAR: Celerity of a multidisciplinary approach and its prognostic implications

Authors

DOI:

https://doi.org/10.48750/acv.483

Keywords:

Aortic aneurysm, endovascular, graft infection, aortoesophageal fistula, thoracic aorta

Abstract

INTRODUCTION: Secondary Aortoesophageal fistula (AEF) is a rare but serious complication following thoracic endovascular aneurysm repair (TEVAR), which may lead to fatal outcomes.

CASE REPORT: We present the case of a 62-year-old patient developing a secondary AEF one-month after TEVAR. The patient was managed in a staged approach: first, an oesophagus defunctionalisation by cervical oesophagus stapling, followed by drainage gastrostomy and creation of a feeding jejunostomy. Two-weeks later, the patient underwent stent graft explantation, extensive debridement, in situ aortic reconstruction with interposition of a silver and Triclosan impregnated Dacron graft, esophagectomy, eosophagogastrostomy and intercostal muscle flap plasty. After 4 years of follow-up, the patient remains clinically well and free from recurrence.

CONCLUSION: The diagnosis of AEF requires a high index of suspicion. A prompt and aggressive multidisciplinary approach is necessary to obtain long-term survival and freedom from recurrence.

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References

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Published

2023-03-23

How to Cite

1.
Henrique A, Quintas A, Aragão Morais J, Oliveira Martins F, Garcia R, Bento R, Pais F, Ferreira ME. Aortoesophageal fistula following TEVAR: Celerity of a multidisciplinary approach and its prognostic implications. Angiol Cir Vasc [Internet]. 2023 Mar. 23 [cited 2024 Mar. 28];18(4):245-8. Available from: https://acvjournal.com/index.php/acv/article/view/483

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Section

Clinical Case