Okubo Ryo, Shirasaka Tomonori, Shibagaki Keisuke, Kamiya Hiroyuki
Department of Cardiac Surgery, Asahikawa Medical University, Asahikawa, Japan.
J Surg Case Rep. 2021 Oct 25;2021(10):rjab356. doi: 10.1093/jscr/rjab356. eCollection 2021 Oct.
An 81-year-old man was transferred to our hospital for a ruptured infected descending aortic aneurysm. An emergency thoracic endovascular aortic repair was performed, but a computed tomography scan 7 days later revealed an aortoesophageal fistula. The establishment of extracorporeal circulation using the femoral artery and utilization of the omentum was considered difficult. We performed bilateral axillofemoral bypass followed by descending aortic resection and esophagectomy. However, the patient's circulatory insufficiency worsened, and he died on the 18th postoperative day. In the treatment of aortoesophageal fistula, bilateral axillofemoral bypass is not recommended as an alternative to descending aortic replacement.
一名81岁男性因降主动脉瘤破裂感染被转至我院。行急诊胸段血管腔内主动脉修复术，但7天后的计算机断层扫描显示存在主动脉食管瘘。考虑到使用股动脉建立体外循环以及利用大网膜存在困难。我们进行了双侧腋股旁路移植术，随后行降主动脉切除术和食管切除术。然而，患者的循环功能不全恶化，术后第18天死亡。在主动脉食管瘘的治疗中，不建议将双侧腋股旁路移植术作为降主动脉置换术的替代方法。
