Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
Ann Thorac Surg. 2012 Feb;93(2):650-1. doi: 10.1016/j.athoracsur.2011.07.031.
A 35-year-old woman presented with an aortobronchial fistula after polyester graft replacement of coarctation of the descending thoracic aortic. Treatment of the fistula included antibiotic therapy and stent graft placement. Life-threatening sepsis developed in the postoperative period. Subsequent treatment required excision of the infected graft complex with extra-anatomic reconstruction of the thoracic aorta. The patient had a very stormy postoperative course and required heroic measures, including mechanical circulatory support, to achieve survival. The present case demonstrates failure of endovascular therapy of an aortobronchial fistula. The case should serve as a cautious reminder that the underlying cause for infection remains even after apparent successful endovascular therapy.
一位 35 岁女性因降主动脉缩窄的聚酯移植物置换后出现主动脉支气管瘘。瘘的治疗包括抗生素治疗和支架移植物放置。术后发生危及生命的败血症。随后的治疗需要切除感染的移植物复合物，并进行胸主动脉的解剖外重建。患者术后病情非常不稳定，需要采取英勇措施，包括机械循环支持，以实现生存。本病例表明主动脉支气管瘘的血管内治疗失败。该病例应谨慎提醒，即使在明显成功的血管内治疗后，感染的根本原因仍然存在。
