胸主动脉腔内修复术治疗主动脉食管瘘：病例系列
Thoracic endovascular aortic repair in management of aorto-oesophageal fistulas: a case series.
作者信息
Vijayvergiya Rajesh, Kasinadhuni Ganesh, Sinha Saroj Kant, Yadav Thakur Deen, Singh Harkant, Savlania Ajay, Lal Anupam, Kanabar Kewal
机构信息
Department of Cardiology, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.
Department of Gastroenterology, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.
出版信息
Eur Heart J Case Rep. 2020 Sep 9;4(5):1-6. doi: 10.1093/ehjcr/ytaa295. eCollection 2020 Oct.
BACKGROUND
Aorto-oesophageal fistula (AOF) is a rare, catastrophic disease with an extremely poor prognosis. A ruptured thoracic aortic aneurysm is a common aetiology for AOF. The clinical presentation is usually massive haematemesis and collapse. Timely diagnosis and appropriate treatment are crucial in managing AOF.
CASE SUMMARY
We hereby report two cases of AOF, who underwent successful emergency thoracic endovascular aortic repair (TEVAR) to control active bleed and exsanguination. Case 1, an elderly lady with atherosclerotic aneurysm had TEVAR followed by open surgery for oesophageal rent and necrosed left main bronchus. Case 2 had mycotic tubercular aneurysm who later had infected graft-stent following TEVAR.
DISCUSSION
Open surgery is the conventional treatment for AOF; however, TEVAR can be an alternative and less invasive approach in selected high-risk patients. Various management issues related to TEVAR with AOF have been discussed in the article.
背景
主动脉-食管瘘（AOF）是一种罕见的灾难性疾病，预后极差。胸主动脉瘤破裂是AOF的常见病因。临床表现通常为大量呕血和虚脱。及时诊断和适当治疗对AOF的管理至关重要。
病例总结
我们在此报告两例AOF患者，他们成功接受了急诊胸主动脉腔内修复术（TEVAR）以控制活动性出血和失血。病例1是一位患有动脉粥样硬化性动脉瘤的老年女性，接受了TEVAR治疗，随后进行了食管裂口和左主支气管坏死的开放手术。病例2患有霉菌性结核性动脉瘤，在TEVAR后出现了感染的移植物支架。
讨论
开放手术是AOF的传统治疗方法；然而，在选定的高危患者中，TEVAR可以是一种替代的、侵入性较小的方法。本文讨论了与AOF的TEVAR相关的各种管理问题。
Zotero 插件