Surgical treatment of five patients with aortobronchial fistula in the aortic arch

Aortobronchial fistula (ABF) is a rare condition that is almost always fatal in the absence of prompt and proper treatment. However, treatment remains challenging, particularly in the aortic arch. We present six operations for 5 such patients, in which no in-hospital deaths occurred. One patient with mycotic aneurysm died suddenly 10 months postoperatively. Another patient required reoperation 5-months after operation due to additional ABF. No pseudoaneurysms or graft-related complications were observed in the remaining patients. In patients with ABF, performance of operations as soon as possible after onset and minimal dissection of adherent lung tissue appear to improve outcomes. (C) 2004 by The Society of Thoracic Surgeons.