采用三步法治疗慢性B型主动脉夹层后发生的迟发性主动脉食管瘘。

Late-onset aortoesophageal fistula after treatment of a chronic type B aortic dissection with a three-step approach.

作者信息

Usai Marco Virgilio, Gottschalk Antje, Schönefeld Thomas, Schaefers Johannes Frederik, Torsello Giovanni B, Rukosujew Andreas

机构信息

Department of Vascular and Endovascular Surgery, University Hospital Münster, Münster, Germany.

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital Münster, Münster, Germany.

出版信息

J Vasc Surg Cases Innov Tech. 2018 Feb 24;4(1):50-53. doi: 10.1016/j.jvscit.2017.11.010. eCollection 2018 Mar.

DOI:10.1016/j.jvscit.2017.11.010

PMID:29556592

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5856677/

Abstract

Aortoesophageal fistula is a rare but lethal complication after thoracic endovascular repair for thoracic aortic diseases. Extensive treatment is reserved for patients fit for surgery. Various technical approaches have been described; however, mortality rates are still high. Herein, we report a case of a 76-year-old woman with aortoesophageal fistula treated by a three-step treatment approach, with close collaboration between cardiothoracic and general surgery specialists. The patient required tracheostomy after the first procedure, but this was closed at 15 days. She subsequently recovered and is doing well at 3 months after surgery. Staged treatment aims to shorten operative times, to reduce the risk of anesthesia complications, and to provide the patients the time to recover after each procedure.

摘要

主动脉食管瘘是胸主动脉疾病经胸血管腔内修复术后一种罕见但致命的并发症。对于适合手术的患者采用广泛的治疗方法。已经描述了各种技术方法；然而，死亡率仍然很高。在此，我们报告一例76岁女性主动脉食管瘘患者，采用三步治疗方法进行治疗，心胸外科和普通外科专家密切协作。患者在第一次手术后需要气管切开术，但在15天时关闭。她随后康复，术后3个月情况良好。分期治疗旨在缩短手术时间，降低麻醉并发症风险，并为患者提供每次手术后恢复的时间。