Vijayvergiya Rajesh, Kasinadhuni Ganesh, Revaiah Pruthvi C, Lal Anupam, Sharma Ashish, Kumar Rupesh
Department of Cardiology, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.
Department of Radio Diagnosis, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh 160012, India.
Eur Heart J Case Rep. 2020 Oct 19;4(6):1-6. doi: 10.1093/ehjcr/ytaa265. eCollection 2020 Dec.
Aortobronchial fistula (ABF) formation following the rupture of thoracic pseudoaneurysm is a rare clinical entity. Its aetiology includes atherosclerosis, infections, trauma, post-surgery, and post-endovascular aortic repair. The clinical presentation of ABF includes intermittent or massive haemoptysis, acute respiratory distress, hypotension, and even death. These patients require an emergency aortic intervention to stop active haemorrhage. Thoracic endovascular aortic repair (TEVAR) is a less invasive, safe, and effective treatment compared to conventional open surgical repair.
We hereby report three cases of ruptured descending thoracic aortic pseudoaneurysms resulting in a fistula formation. The first two cases had tuberculosis as their underlying aetiology, while the third case was the result of previous open post-aortic surgery. All patients presented with massive haemoptysis and were successfully treated by emergency TEVAR and had favourable outcomes.
Thoracic endovascular aortic repair is a rapid, less invasive, and effective treatment for emergency management of ABF. It has more than 85% technical success rates in the reported literature. We had procedural success in all three cases. The short and midterm outcome of ABF following TEVAR is favourable and encouraging.
胸段假性动脉瘤破裂后形成主动脉支气管瘘（ABF）是一种罕见的临床病症。其病因包括动脉粥样硬化、感染、创伤、手术后以及血管腔内主动脉修复术后。ABF的临床表现包括间歇性或大量咯血、急性呼吸窘迫、低血压，甚至死亡。这些患者需要紧急进行主动脉干预以停止活动性出血。与传统的开放手术修复相比，胸段血管腔内主动脉修复术（TEVAR）是一种侵入性较小、安全且有效的治疗方法。
我们在此报告三例降主动脉胸段假性动脉瘤破裂导致瘘形成的病例。前两例病例的潜在病因是结核病，而第三例病例是先前主动脉手术后的结果。所有患者均出现大量咯血，并通过紧急TEVAR成功治疗，且预后良好。
胸段血管腔内主动脉修复术是一种快速、侵入性较小且有效的治疗ABF紧急情况的方法。在已报道的文献中，其技术成功率超过85%。我们的三例病例手术均成功。TEVAR术后ABF的短期和中期预后良好且令人鼓舞。
