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

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 descri...

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Published inJournal of personalized medicine Vol. 14; no. 6; p. 625
Main Authors Stiru, Ovidiu, Nayyerani, Reza, Robu, Mircea, Geana, Roxana Carmen, Dragulescu, Petru Razvan, Blibie, Oana Andreea, Bubenek-Turconi, Serban-Ion, Iliescu, Vlad Anton, Parasca, Catalina
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 11.06.2024
MDPI
Subjects
Anemia
Antibiotics
Aorta
Cardiovascular system
Coronary vessels
Dysphagia
Emergency medical care
Endoscopy
Esophagus
Fistula
Fistulae
Health aspects
Hematemesis
Hematoma
Hemoglobin
Hemoptysis
Intervention
Medical imaging
Methylene blue
Mortality
Ostomy
Pathogenesis
Patients
Pleural effusion
Precision medicine
Pseudoaneurysm
Review
Surgery
Thorax
Tomography
Ulcers
esophageal stent
secondary aortoesophageal fistula
TEVAR
aortic repair
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Summary: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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ISSN:2075-4426
2075-4426
DOI:10.3390/jpm14060625