Gormley S, Zaman Z, Mani K, Khashram M. Aorto-cutaneous fistula of the ascending aorta-case report and a literature review of endovascular management.
J Vasc Surg Cases Innov Tech 2022;
9:100971. [PMID:
36747605 PMCID:
PMC9898732 DOI:
10.1016/j.jvscit.2022.06.023]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 06/30/2022] [Indexed: 02/08/2023] Open
Abstract
Aorto-cutaneous fistulas are an unusual and life-threatening complication after aortic surgery. We present the case of an endovascular intervention for an aorto-cutaneous fistula of the ascending aorta that was intended to be a bridge to definitive surgical treatment and report a literature review. A 56-year-old woman had a previous Bentall's procedure and mitral valve annuloplasty in 2016. Four years later she re-presented with an infective pseudoaneurysm of the distal anastomosis of the ascending aortic graft, with aorto-cutaneous fistulation. She was at high risk for a revision operation and required optimization before a major open surgery. A thoracic endovascular aortic repair stent graft (Valiant Navion; Medtronic Inc) was implanted to exclude the distal anastomotic pseudoaneurysm. Two months later she re-presented with a new infected pseudoaneurysm at the proximal end of the previously implanted stent graft, and a further thoracic endovascular aortic repair was undertaken.
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