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Case Reports

Successful Management of Esophagoparaprosthetic Fistula After Aortic Surgery

^a Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, Sendai, Japan
^b Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, Sendai, Japan

Accepted for publication October 17, 2007.

^_* Address correspondence to Dr Kawamoto, Department of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan (Email: shunsuke{at}mail.tains.tohoku.ac.jp).

Aortoesophageal fistula is a relatively rare but highly fatal condition, especially in the case of secondary aortoesophageal fistulas after previous thoracic aortic surgery in which the aortic prosthetic graft itself may be involved in the infection, resulting in an esophagoparaprosthetic fistula. In this report, we describe a complicated case of esophagoparaprosthetic fistula arising after descending thoracic aortic replacement and endovascular pseudoaneurysm repair that was successfully treated by surgical resection and in situ aortic graft replacement using a homograft completely covered with an omental flap, combined with subtotal esophagectomy and staged reconstruction of the alimentary tract. The patient has been doing well for 24 months without signs of recurrent infection.