Abstract
A 74-year-old woman with massive hemoptysis and shock who had been diagnosed with thoracic aortic rupture underwent in situ replacement of the thoracic aorta using an equine pericardial roll graft. The lower lobe of the left lung was resected because of a massive hematoma and adhesion to the wall of the thoracic aorta. Intraoperative microscopic examination of the resected aortic wall revealed Gram-positive bacteria (α-streptococcus in bacterial cultivation). Histology of the resected aorta revealed abscess formation in the media and adventitia of the aortic wall associated with disruption of the media (dissection). Postoperative computed tomography revealed no fluid collection around the graft 1 month after surgery, and magnetic resonance imaging showed no significant graft dilation 20 months after operation. The equine pericardium can be an option of alternative graft materials for in situ replacement of the thoracic aorta in patients with an aortobronchial fistula due to aortic rupture.
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Nishizawa J, Matsumoto M, Sugita T, Matsuyama K, Tokuda Y, Yoshida K, et al. Surgical treatment of five patients with aortobronchial fistula in the aortic arch. Ann Thorac Surg 2004;77:1821–1823.
Demeter SL, Cordasco EM. Aortobronchial fistula: keys to successful management. Angiology 1980;31:431–435.
Eren E, Keles C, Toker ME, Ersahin S, Erentug V, Guler M, et al. Surgical treatment of aortobronchial and aortoesophageal fistulae due to thoracic aortic aneurysm. Tex Heart Inst J 2005;32:522–528.
Coblentz CL, Sallee DS, Chiles C. Aortobronchial fistula complicating aortic aneurysm: diagnosis in four cases. Eur J Cardiothorac Surg 1997;12:195–201.
Otte G, Pennsylvania Y, Seebass JS. Aortobronchial fistula causing hemoptysis in a patient with a Dacron aortic patch graft: report of a case. J Am Osteopath Assoc 1984;83:442–445.
Paull DE, Keagy BA. Management of aortobronchial fistula with graft replacement and omentopexy. Ann Thorac Surg 1990;50:972–974.
Ishizaki Y, Tada Y, Takagi A, Sato O, Takayama Y, Shirakawa M, et al. Aortobronchial fistula after an aortic operation. Ann Thorac Surg 1990;50:975–977.
Koh M, Yagihara T, Uemura H, Kagisaki K, Hagino I, Ishizaka T, et al. Long-term outcome of right ventricular outflow tract reconstruction using a handmade tri-leaflet conduit. Eur J Cardiothorac Surg 2005;27:807–814.
Takeuchi K, Murakami A, Sekiguchi A, Hirata Y, Maeda K, Kitahori K, et al. Fate of equine pericardial roll conduit for the Rastelli operation during long-term follow-up. Congenit Heart Dis 2007;2:121–124.
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Yamamoto, H., Yamamoto, F., Ishibashi, K. et al. In situ replacement of the thoracic aorta using an equine pericardial roll graft for an aortobronchial fistula due to aortic rupture. Gen Thorac Cardiovasc Surg 57, 413–417 (2009). https://doi.org/10.1007/s11748-008-0388-7
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DOI: https://doi.org/10.1007/s11748-008-0388-7