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Case Reports

Two-Stage Safe Repair of Aortobronchial Fistula

^a Division of Vascular and Endovascular Surgery, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
^b Department of Cardiothoracic and Vascular Surgery, University of Texas Medical School, Houston, Texas

Accepted for publication June 4, 2009.

^_* Address correspondence to Dr Estrera, 6400 Fannin St, Ste 2850, Houston, TX 77030 (Email: anthony.l.estrera{at}uth.tmc.edu).

Aortobronchial fistulas are a rare and frequently misdiagnosed cause of massive hemoptysis, which is often fatal. Aortic stent grafts now allow for a safer emergency repair. However, there is a high (40% to 50%) recurrence risk, with a high fatality rate. A patient with an aortobronchial fistula due to a ruptured thoracic aortic aneurysm underwent a two-stage repair. An aortic stent graft was deployed as an emergency, and a second surgical durable repair was performed 4 months later. The patient recovered well. The best management of aortobronchial fistula may be emergency use of stent graft, followed by a delayed durable open repair when the patient has achieved stability.