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Ann Thorac Surg 1996;62:588-590
© 1996 The Society of Thoracic Surgeons


Case Report

Aortoesophageal Fistula After Repair of Descending Aortic Dissection

Rose S. Wong, MD, Anna Champlin, MD, R. Thomas Temes, MD, Jorge A. Wernly, MD

Division of Thoracic and Cardiovascular Surgery and Department of Radiology, University of New Mexico, Albuquerque, New Mexico

Accepted for publication March 2, 1996.

The development of aortoesophageal fistula after aortic repair is rare. We describe a patient who presented with hematemesis 4 months after emergent repair of a descending thoracic aortic dissection using a prosthetic graft. Diagnosis was supported by computed tomographic, angiographic, and endoscopic findings. Resection of the involved graft was performed through a left thoracotomy after placement of an ascending aorta-to-abdominal aorta conduit through an anterior approach. The patient died of uncontrollable bleeding a few hours after the procedure. Surgical intervention offers the potential for cure in this otherwise uniformly fatal condition. But like medical therapy, operative management has thus far been associated with 100% mortality.




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