Combined Endovascular and Endoscopic Management of a Secondary Aortoesophageal Fistula after Open Surgical Aortic Repair in a Giant Descending Thoracic Aortic Pseudoaneurysm: Case Report and Review of Literature

被引:1
作者
Stiru, Ovidiu [1 ,2 ]
Nayyerani, Reza [1 ,2 ]
Robu, Mircea [1 ,2 ]
Geana, Roxana Carmen [2 ]
Dragulescu, Petru Razvan [2 ]
Blibie, Oana Andreea [3 ]
Bubenek-Turconi, Serban-Ion [1 ,3 ]
Iliescu, Vlad Anton [1 ,2 ]
Parasca, Catalina [1 ,2 ]
机构
[1] Carol Davila Univ Med & Pharm, Fac Med, Bucharest 050474, Romania
[2] Prof Dr CC Iliescu Emergency Inst Cardiovasc Dis, Dept Cardiac Surg, Bucharest 022322, Romania
[3] Prof C C Iliescu Emergency Inst Cardiovasc Dis, Dept Cardiovasc Anesthesiol & Intens Care 1, Bucharest 022328, Romania
关键词
secondary aortoesophageal fistula; TEVAR; esophageal stent; aortic repair; STENT; GRAFT;
D O I
10.3390/jpm14060625
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Secondary aortoesophageal fistula (AEF) is defined as a communication between the aorta and the esophagus, occurring after aortic disease treatment or esophageal procedures, associating very high mortality rates with treatment and being fatal without it. Several treatment strategies have been described in the literature, combining open surgery or endovascular aortic repair with surgical or endoscopic management of the esophageal lesion. We present the case of a 53-year-old patient with a history of open aortic surgery for a giant descending thoracic aortic pseudoaneurysm complicated with secondary AEF, successfully managed using emergency transiliac TEVAR (thoracic endovascular aortic repair), extensive antibiotic therapy associated with nutritional replenishment, and rehabilitation therapy. Novel endovascular and endoscopic devices have been developed, offering less invasive treatment strategies with improved outcomes, especially for high risk surgical patients. This case highlights the importance of a multidisciplinary approach to personalized medicine to manage such complex situations.
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