Ikuno Takeshi, Sakakibara Yutaka, Seki Yusuke, Nishimura Kazunobu
Department of Cardiac Surgery, Kyoto Medical Hospital, Kyoto, JPN.
Department of Cardiovascular Surgery, Takamatsu Red Cross Hospital, Takamatsu, JPN.
Cureus. 2024 Aug 19;16(8):e67169. doi: 10.7759/cureus.67169. eCollection 2024 Aug.
Aortoesophageal fistula (AEF) caused after thoracic endovascular aortic repair (TEVAR) is rare but a serious complication. We report a successful staged operation for AEF after TEVAR. A 70-year-old male underwent TEVAR for a ruptured aneurysm of the descending aorta and subsequently developed AEF three months later. First, the patient underwent the resection of the esophagus, which was the focus of the infection under the right thoracoscopic approach. Second, descending aorta replacement was performed using a left thoracotomy approach. The patient has been well for about two years since the second operation without recurring graft infection. Staged operation with a different approach to the infection zone is a useful method for AEF.
胸主动脉腔内修复术（TEVAR）后引发的主动脉食管瘘（AEF）虽罕见，但却是一种严重的并发症。我们报告了一例TEVAR术后AEF的成功分期手术。一名70岁男性因降主动脉瘤破裂接受了TEVAR手术，随后在三个月后发生了AEF。首先，患者在右胸镜入路下切除了作为感染病灶的食管。其次，采用左胸切开术入路进行降主动脉置换。自第二次手术后，患者情况良好，约两年未出现移植感染复发。针对感染区域采用不同入路的分期手术是治疗AEF的一种有效方法。
