Angiologia e Cirurgia Vascular
ISSN 1646-706X
HENRIQUE, Alberto et al. Aortoesophageal fistula following TEVAR: Celerity of a multidisciplinary approach and its prognostic implications. []. , 18, 4, pp.245-248. 28--2023. ISSN 1646-706X. https://doi.org/10.48750/acv.483.
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.
: Aortic aneurysm; endovascular; graft infection; aortoesophageal fistula; thoracic aorta.