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Primary aortoesophageal fistula secondary to thoracic aneurysm

Successful surgical treatment by extra-anatomic bypass grafting
  • Iwao Taniguchi
  • Naoaki Takemoto
  • Takeshi Yamaga
  • Keisuke Morimoto
  • Shigeto Miyasaka
  • Takako Suda
Article

Abstract

Aortoesophageal fistula (AEF) secondary to thoracic aneurysm is rare, and is usually fatal without prompt surgical intervention, with few survivors reported. Here we report a case of a 68-year-old woman late-presenting AEF successfully treated by extra-anatomic bypass grafting. Since she had already a mediastinal infection caused by AEF on admission, we performed extra-anatomic bypass grafting from the ascending aorta to the infrarenal aorta, and primary esophageal repair. The extra-anatomic bypass grafting was performed to avoid the risk to secondary graft infection and to decrease the total ishemic time induced by intraoperative aortic clamping, which is necessary when in-situ graft replacement is chosen. Although only 17 cases (including the present case) have been reported as long-term survivors, most have involved in-situ repair of the thoracic aneurysm. To our knowledge, the present case was only the second treated successfully by extra-anatomic bypass grafting. We recommend extra-anatomic bypass grafting for a case with severe infection and prolonged hypoperfusion insult caused by massive bleeding due to rupture in an aneurysm.

Key words

aortoesophageal fistula thoracic aneurysm extra-anatomic bypass grafting 

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Copyright information

© The Japanese Society of Thoracic and Cardiovascular Surgery 2002

Authors and Affiliations

  • Iwao Taniguchi
    • 1
  • Naoaki Takemoto
    • 1
  • Takeshi Yamaga
    • 1
  • Keisuke Morimoto
    • 1
  • Shigeto Miyasaka
    • 1
  • Takako Suda
    • 1
  1. 1.Department of Thoracic and Cardiovascular SurgeryTottori Prefectural Central HospitalTottoriJapan

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