Ochoa Chaar Cassius Iyad, Zafar Mohammad A, Velasquez Camilo, Saeyeldin Ayman, Elefteriades John A
Section of Vascular and Endovascular Surgery, Yale University School of Medicine, New Haven, Conn.
Aortic Institute at Yale-New Haven Hospital, Yale University School of Medicine, New Haven, Conn.
J Vasc Surg Cases Innov Tech. 2019 Jun 25;5(3):261-263. doi: 10.1016/j.jvscit.2019.02.011. eCollection 2019 Sep.
Aortoesophageal fistula after thoracic endovascular aortic repair is a rare but fatal complication, and no clear guidelines exist in the literature for optimal management. Herein, we report a complex case of a patient with an infected thoracic endograft that led to an aortoesophageal fistula. The treatment comprised a two-stage open surgical approach-an extra-anatomic aortic bypass in the first stage, followed by explantation of the infected endograft with ligation of the descending thoracic aorta in the second. This approach controls the focus of infection while allowing flow to the aorta distal to the infected endograft, minimizing visceral ischemia time.
胸主动脉腔内修复术后发生主动脉食管瘘是一种罕见但致命的并发症,文献中尚无关于最佳治疗方案的明确指南。在此,我们报告一例复杂病例,患者因感染性胸段人工血管移植物导致主动脉食管瘘。治疗采用两阶段开放手术方法:第一阶段进行解剖外主动脉旁路移植术,第二阶段切除感染的人工血管移植物并结扎胸降主动脉。这种方法可控制感染病灶,同时使血流流向感染人工血管移植物远端的主动脉,最大限度地缩短内脏缺血时间。