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Ann Thorac Surg 2002;74:247-249
© 2002 The Society of Thoracic Surgeons

Case report

Endovascular treatment of thoracic aortic fistulas

Bertrand Léobon, MDa, Daniel Roux, MDa, Antoine Mugniot, MDa, Hervé Rousseau, MDb, Alain Cérene, MDa, Yves Glock, MDa, Gérard Fournial, MD*a

a Department of Cardiovascular Surgery A and B, Rangueil Hospital, Toulouse, France
b Department of Radiology, Rangueil Hospital, Toulouse, France

Accepted for publication January 21, 2002.

* Address reprint requests to Pr Fournial, Service de Chirurgie Cardio-Vasculaire B, CHU Rangueil, 1 av J Poulhes, 31403 Toulouse, Cedex 4, France
e-mail: fournial.g{at}chu-toulouse.fr

Aortoesophageal and aortobronchial fistulas constitute a problem in therapy because of the high rates of morbidity and mortality associated with operation. From May 1996 to March 2000, we treated by an endovascular procedure one aortoesophageal and three aortobronchial fistulas. There was no postoperative death. We noted one peripheral vascular complication that required a surgical procedure, one postoperative confusion, and one inflammatory syndrome. In one case, because of a persistent leakage after 21 months, we had to implant a second endovascular stent graft. A few weeks later the reopening of this patient’s esophageal fistula led to his death by mediastinitis 25 months after the first procedure. The few cases published seem to bear out the interest, observed in our 4 patients, of an endovascular approach to treat complex lesions such as fistulas of the thoracic aorta especially in emergency or palliative cases.




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