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Ann Thorac Surg 2005;80:1117-1120
© 2005 The Society of Thoracic Surgeons

Case report

Successful Treatment of an Aortoesophageal Fistula After Emergency Endovascular Thoracic Aortic Stent-Graft Placement

Martin Czerny, MD * , Daniel Zimpfer, MD, Tatjana Fleck, MD, Roman Gottardi, MS, Manfred Cejna, MD, Maria Schoder, MD, Johannes Lammer, MD, Ernst Wolner, MD, Martin Grabenwoger, MD, Michael-Rolf Mueller, MD

Departments of Cardiothoracic Surgery and Interventional Radiology, University of Vienna Medical School, Vienna, Austria

Accepted for publication February 18, 2004.

* Address reprint requests to Dr Czerny, Waehringer Guertel 18-20, Vi-enna, Austria A-1090 (Email: bypass{at}eunet.at).

We report the case of a 57-year-old man who underwent emergency stent-graft placement in August 2003 due to a contained rupture of a distal descending aortic aneurysm. After 1 month the patient was readmitted with chest pain as well as swallowing disorders. A computed tomographic scan revealed a fistula between the distal esophagus and the excluded aneurysm sac. The patient was treated by an esophagectomy, a cervical esophagostomy, as well as a feeding gastrostomy. The infectious parietal thrombus was partially debrided and the aneurysm sac was filled with vancomycin. After 3 months continuity was reinstalled with a pedicled isoperistaltic transverse colonic conduit. The patient recovered uneventfully. At a 3 month follow-up, he showed no signs of infection. However, he is still being treated with antibiotic therapy of ciprofloxacin for a minimum of 1 year.




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