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Ogino H, Iida O, Akutsu K, Chiba Y, Hayashi H, Ishibashi-Ueda H, Kaji S, Kato M, Komori K, Matsuda H, Minatoya K, Morisaki H, Ohki T, Saiki Y, Shigematsu K, Shiiya N, Shimizu H, Azuma N, Higami H, Ichihashi S, Iwahashi T, Kamiya K, Katsumata T, Kawaharada N, Kinoshita Y, Matsumoto T, Miyamoto S, Morisaki T, Morota T, Nanto K, Nishibe T, Okada K, Orihashi K, Tazaki J, Toma M, Tsukube T, Uchida K, Ueda T, Usui A, Yamanaka K, Yamauchi H, Yoshioka K, Kimura T, Miyata T, Okita Y, Ono M, Ueda Y. JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection. Circ J 2023; 87:1410-1621. [PMID: 37661428 DOI: 10.1253/circj.cj-22-0794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/05/2023]
Affiliation(s)
- Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Osamu Iida
- Cardiovascular Center, Kansai Rosai Hospital
| | - Koichi Akutsu
- Cardiovascular Medicine, Nippon Medical School Hospital
| | - Yoshiro Chiba
- Department of Cardiology, Mito Saiseikai General Hospital
| | | | | | - Shuichiro Kaji
- Department of Cardiovascular Medicine, Kansai Electric Power Hospital
| | - Masaaki Kato
- Department of Cardiovascular Surgery, Morinomiya Hospital
| | - Kimihiro Komori
- Division of Vascular and Endovascular Surgery, Department of Surgery, Nagoya University Graduate School of Medicine
| | - Hitoshi Matsuda
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center
| | - Kenji Minatoya
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
| | | | - Takao Ohki
- Division of Vascular Surgery, Department of Surgery, The Jikei University School of Medicine
| | - Yoshikatsu Saiki
- Division of Cardiovascular Surgery, Graduate School of Medicine, Tohoku University
| | - Kunihiro Shigematsu
- Department of Vascular Surgery, International University of Health and Welfare Mita Hospital
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine
| | | | - Nobuyoshi Azuma
- Department of Vascular Surgery, Asahikawa Medical University
| | - Hirooki Higami
- Department of Cardiology, Japanese Red Cross Otsu Hospital
| | | | - Toru Iwahashi
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Kentaro Kamiya
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Takahiro Katsumata
- Department of Thoracic and Cardiovascular Surgery, Osaka Medical College
| | - Nobuyoshi Kawaharada
- Department of Cardiovascular Surgery, Sapporo Medical University School of Medicine
| | | | - Takuya Matsumoto
- Department of Vascular Surgery, International University of Health and Welfare
| | | | - Takayuki Morisaki
- Department of General Medicine, IMSUT Hospital, the Institute of Medical Science, the University of Tokyo
| | - Tetsuro Morota
- Department of Cardiovascular Surgery, Nippon Medical School Hospital
| | | | - Toshiya Nishibe
- Department of Cardiovascular Surgery, Tokyo Medical University
| | - Kenji Okada
- Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine
| | | | - Junichi Tazaki
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | - Masanao Toma
- Department of Cardiology, Hyogo Prefectural Amagasaki General Medical Center
| | - Takuro Tsukube
- Department of Cardiovascular Surgery, Japanese Red Cross Kobe Hospital
| | - Keiji Uchida
- Cardiovascular Center, Yokohama City University Medical Center
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School
| | - Akihiko Usui
- Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
| | - Kazuo Yamanaka
- Cardiovascular Center, Nara Prefecture General Medical Center
| | - Haruo Yamauchi
- Department of Cardiac Surgery, The University of Tokyo Hospital
| | | | - Takeshi Kimura
- Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University
| | | | - Yutaka Okita
- Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine
| | - Minoru Ono
- Department of Cardiac Surgery, Graduate School of Medicine, The University of Tokyo
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Endovascular Repair of Aortobronchial Fistula due to Saccular Aneurysm of Thoracic Aorta. Case Rep Vasc Med 2017; 2017:3158693. [PMID: 29279784 PMCID: PMC5723941 DOI: 10.1155/2017/3158693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 11/09/2017] [Indexed: 12/01/2022] Open
Abstract
Aortobronchial fistula (ABF) is a rare condition which can be lethal if left untreated. Open surgical treatment carries high morbidity and mortality. Recent advances in endovascular technology have made thoracic endovascular aortic repair (TEVAR) the treatment of choice. We present a successful endovascular repair of aortobronchial fistula due to a saccular aneurysm of descending thoracic aorta.
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Aortobronchial Fistula after Thoracic Endovascular Aortic Repair (TEVAR) for Descending Thoracic Aortic Aneurysm. Ann Vasc Surg 2017; 41:283.e1-283.e4. [DOI: 10.1016/j.avsg.2016.10.040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 09/07/2016] [Accepted: 10/13/2016] [Indexed: 11/18/2022]
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Böckler D, Schumacher H, Schwarzbach M, Ockert S, Rotert H, Allenberg JR. Endoluminal Stent-Graft Repair of Aortobronchial Fistulas: Bridging or Definitive Long-Term Solution? J Endovasc Ther 2016; 11:41-8. [PMID: 14748630 DOI: 10.1177/152660280401100105] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To describe our experience with endoluminal stent-graft repair of aortobronchial fistulas (ABF) and to analyze midterm results focusing on late chronic graft infections, secondary conversion, and survival. Methods: The records of 8 patients (6 men; mean age 69 years, range 28–88) treated between March 1997 and October 2003 for traumatic and postsurgical ABFs were reviewed. Seven presented with hemoptysis and 1 with hemorrhagic shock. According to the severity of emergency, patients underwent computed tomography, angiography, bronchoscopy, and transesophageal echocardiography. Preoperatively, no clinical signs of infection were evident. Two different stent-graft models (Talent and Excluder) were implanted using standard endovascular techniques. Results: Procedural and clinical success was achieved in all patients. Paraplegia, secondary intervention, conversion, or procedure-related death was not observed. Mean follow-up was 30 months (range 0.6–77). One patient with a postsurgical ABF (Dacron tube graft) successfully treated with an Excluder stent-graft died 13 months later from hemorrhage secondary to aortoesophageal fistula repair procedures. A second patient died from pneumonia after 42 months. A third patient, in whom 2 Talent stent-grafts had been implanted to treat an ABF from the false lumen of a type B dissection, died 7 months later from massive hemorrhage. Conclusions: Endoluminal stent-grafting of ABF is feasible and the preferred method of treatment. Secondary conversion due to endograft infection is not absolutely mandatory, but close surveillance is necessary.
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Affiliation(s)
- Dittmar Böckler
- Department of Vascular and Endovascular Surgery, Ruprecht-Karls University Heidelberg, Germany.
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Versnaeyen H, Saey V, Vermeiren D, Chiers K, Ducatelle R. Intermittent Haemoptysis due to an Aortobronchial Fistula in a Warmblood Mare. J Comp Pathol 2016; 155:213-217. [PMID: 27535296 DOI: 10.1016/j.jcpa.2016.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 07/03/2016] [Accepted: 07/12/2016] [Indexed: 10/21/2022]
Abstract
A 7-year-old warmblood mare showed sudden onset of mild intermittent haemoptysis. Clinical examination revealed no significant abnormalities. Haematological examination showed mild anaemia, hypoalbuminaemia and neutrophilia. Coagulation tests were normal. Endoscopic examination revealed unilateral pulmonary haemorrhage with blood clots in the bronchi and trachea. Treatment with antibiotics was started and the horse was given stable rest. Two weeks later, the horse was found dead with blood and frothy sputum leaking from the nostrils. Post-mortem examination revealed a large thoracic aortic aneurysm communicating with a pseudoaneurysm that had formed a fistula into a right bronchial branch. Microscopical examination of the aneurysm showed extensive medial fibrosis with prominent degeneration, fragmentation and mineralization of the elastic fibres and deposition of mucoid material in the tunica media. The pseudoaneurysm was lined by collagen bundles admixed with fibroblasts and a small amount of adipose tissue. Aortobronchial fistula is a rare condition in man that is usually associated with primary aortic pathology, most often aneurysms. To the authors' knowledge this is the first case of a fatal aortobronchial fistula in a horse or any other animal species.
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Affiliation(s)
- H Versnaeyen
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Ghent, Belgium.
| | - V Saey
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Ghent, Belgium
| | - D Vermeiren
- Veterinary Practice, Perbeemd, Sint-Lenaartseweg 67, Loenhout, Belgium
| | - K Chiers
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Ghent, Belgium
| | - R Ducatelle
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Ghent, Belgium
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6
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Canaud L, Ozdemir BA, Bahia S, Hinchliffe R, Loftus I, Thompson M. Thoracic Endovascular Aortic Repair for Aortobronchial Fistula. Ann Thorac Surg 2013; 96:1117-21. [DOI: 10.1016/j.athoracsur.2013.04.090] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/12/2013] [Accepted: 04/15/2013] [Indexed: 10/26/2022]
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7
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Li M, Langlois N, Byard RW. Fatal aortobronchial fistula. J Forensic Leg Med 2012; 20:395-8. [PMID: 23756504 DOI: 10.1016/j.jflm.2012.07.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2012] [Accepted: 07/27/2012] [Indexed: 11/26/2022]
Abstract
Aortobronchial fistula is a rare condition characterized by the development of a communication between the aorta and a branch of the bronchial tree that results from processes that arise within the aorta, in the tissues of the mediastinum, or in the adjacent thoracic organs. Three cases are reported to demonstrate characteristic features. Case 1: An 82-year-old woman was found collapsed with blood clot in her mouth. At autopsy an atherosclerotic thoracic aortic aneurysm was found which had eroded into the underlying left main bronchus with filling of the larynx, trachea and main bronchi with fluid blood. There was no evidence of dissection. Case 2: A 30-year-old woman collapsed and died. At autopsy, coarctation of the thoracic aorta was found with a saccular aneurysm distal to this which was joined to the left main bronchus by a mass of necrotic tissue. The bronchus contained a cast of blood; blood was also present within the trachea and within the distal airways of the left lung. Case 3: A six-year-old girl collapsed with massive airway haemorrhage following bronchoscopy. At autopsy coarctation of the thoracic aorta was identified with a saccular aneurysm distal to this. A transverse tear of the thinned aneurysm wall communicated with a mass of necrotic friable tissue that extended through the wall of the left main bronchus. Distal airways were filled with fluid blood. All three deaths were due to haemorrhage from aortobronchial fistulas. The pathogenesis of aortobronchial fistulas involves a variety of mechanical, infective and neoplastic processes. Many cases will not be diagnosed until autopsy examination is performed.
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Affiliation(s)
- Mo Li
- The University of Adelaide Medical School, Frome Road, Adelaide 5005, SA, Australia
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Younie PS, Man J, Baig K, Mathew T. Percutaneous repair of an aortopulmonary fistula using platinum coils. Br J Hosp Med (Lond) 2012; 73:228-9. [PMID: 22585201 DOI: 10.12968/hmed.2012.73.4.228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- P S Younie
- Department of Anaesthesia, Royal Surrey County Hospital, Guildford GU1 2HT.
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9
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Nguyen T, Peters P, McGahan T, Shah P. Staged management of a primary aortobronchial fistula: a novel approach using a trapezius flap repair. Heart Lung Circ 2012; 21:292-4. [PMID: 22464594 DOI: 10.1016/j.hlc.2012.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 11/06/2011] [Accepted: 01/17/2012] [Indexed: 11/17/2022]
Abstract
There have been few reported cases of management of an aortobronchial fistula. We describe the case of a 68 year-old male with a very high operative risk who had a successful staged management of a primary aortobronchial fistula. An endovascular stent was placed initially, however due to recurrence of the fistula a second stent was deployed within the first one some three months after. Fifteen months later he represented with massive haemoptysis, severe cachexia and at this stage the best course of surgical management was thought to be lobectomy via thoracotomy followed by trapezius flap overlay covering the exposed stent and separating it from the remaining lung.
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Affiliation(s)
- Tam Nguyen
- Department of Cardiothoracic Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia
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Valente T, Rossi G, Lassandro F, Rea G, Marino M, Dialetto G, Muto R, Scaglione M. Unusual complications of endovascular repair of the thoracic aorta: MDCT findings. Radiol Med 2012; 117:831-54. [PMID: 22228128 DOI: 10.1007/s11547-011-0771-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2011] [Accepted: 06/20/2011] [Indexed: 11/26/2022]
Abstract
With the development of minimally invasive surgical techniques, endovascular stent-graft placement has become an accepted and widely used alternative to the traditional surgical repair of aortic disease and is gaining acceptance as the treatment of choice. Many studies show that endovascular stent-graft therapy is safe and effective, although complications related to this treatment are also recognised. Although the incidence of major complication is low, neurological sequelae remain the major concern of endovascular repair. With growing experience, however, the spectrum of mid- and long-term complications has broadened to include potentially disastrous events, other than paraplegia or stroke, that require diligent surveillance. Three-dimensional data sets acquired quickly by multidetector computed tomography (MDCT) allow multiplanar reformations and 3D viewing, as well as quantitative assessment of vessel lumens, walls and surroundings. Although a large portion of radiologists will not be involved in the actual endograft deployment, many will be involved in the interpretation of postprocedural surveillance studies. Accordingly, the goal of this report is to summarise our experience with the presentation, diagnostic approach, management and outcomes of these unusual, but potentially catastrophic, postendovascular aortic repair complications to highlight their significance and increase familiarity with them among the imaging community. Increasing awareness of these complications may facilitate rapid diagnosis and/or triage and treatment.
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Affiliation(s)
- T Valente
- Dipartimento di Diagnostica per Immagini, Servizio di Radiologia, A.O.R.N. Monaldi, 80131, Napoli, Italy
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Bailey CJ, Force S, Milner R, Kasirajan K, Veeraswamy RK. Thoracic endovascular repair as a safe management strategy for aortobronchial fistulas. J Vasc Surg 2011; 53:1202-9; discussion 1209. [DOI: 10.1016/j.jvs.2010.10.103] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2010] [Revised: 10/13/2010] [Accepted: 10/16/2010] [Indexed: 11/16/2022]
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Neves AAG, Oliveira AGNMD, Beck RT, Santos RVD, Moreira FCP, Amato ACM. Tratamento endovascular de pseudoaneurisma de aorta torácica com fístula aorto-brônquica em pós-operatório tardio de cirurgia de correção de coarctação de aorta. J Vasc Bras 2011. [DOI: 10.1590/s1677-54492011000100012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Fístula aorto-brônquica é uma conexão entre a aorta e o brônquio, e mesmo quando imediatamente reconhecida e tratada possui alto risco de letalidade. Pode se desenvolver após cirurgias de aorta, e é geralmente uma consequência de pseudoaneurisma. A hemoptise, massiva ou intermitente, é o principal sintoma apresentado. O tratamento convencional da fístula aorto-brônquica é a cirurgia aberta de aorta torácica, com reconstrução traqueobrônquica. Recentemente, o reparo endovascular tem sido proposto como uma alternativa. Os autores apresentam um relato de tratamento endovascular, realizado com êxito, de pseudoaneurisma de aorta torácica com fístula aorto-brônquica 22 anos após cirurgia para correção de coarctação aórtica.
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Yanagida R, Kass R, Czer L, Khoynezhad A. Endovascular repair of arterio-bronchial fistula of the outflow graft of HeartMate II left ventricular assist device. J Thorac Cardiovasc Surg 2011; 142:710-1. [PMID: 21272896 DOI: 10.1016/j.jtcvs.2010.11.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 11/15/2010] [Indexed: 11/19/2022]
Affiliation(s)
- Roh Yanagida
- Division of Cardiothoracic Surgery, Cedars-Sinai Heart Institute, Los Angeles, Calif, USA.
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De Rango P, Estrera AL, Azizzadeh A, Safi HJ. Stent-Graft Repair of Aortobronchial Fistula: A Review. J Endovasc Ther 2009; 16:721-32. [DOI: 10.1583/09-2800.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Jonker FHW, Schlösser FJV, Moll FL, van Herwaarden JA, Indes JE, Verhagen HJM, Muhs BE. Outcomes of thoracic endovascular aortic repair for aortobronchial and aortoesophageal fistulas. J Endovasc Ther 2009; 16:428-40. [PMID: 19702348 DOI: 10.1583/09-2741r.1] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To identify in-hospital and follow-up outcomes of thoracic endovascular aortic repair (TEVAR) for aortobronchial fistula (ABF) and aortoesophageal fistula (AEF). METHODS The authors reviewed all published cases of ABF and AEF undergoing TEVAR indexed in the MEDLINE, Cochrane Library CENTRAL, and EMBASE databases. After removal of duplicates, 850 articles were scrutinized for relevance and validity. Exclusion criteria included: (1) no clear description of the organs involved with the fistula, (2) no description of outcomes after TEVAR for ABF or AEF, or (3) no original data presented in the article. In this manner, 66 relevant articles were identified that included original data on 114 patients (76 men; mean age 63+/-1.5 years) with ABF (n = 71) or AEF (n = 43). Meta-analyses were performed to investigate outcomes of TEVAR for ABF and AEF. RESULTS Patients with AEF presented more frequently with hypovolemic shock (33% versus 13%, p = 0.012) and systemic infection (36% versus 9%, p<0.001) compared to patients with ABF. In-hospital mortality was 3% (n = 2) after TEVAR for ABF and 19% (n = 8) after TEVAR for AEF (p = 0.004). Additional thoracic surgery in the first 30 days after TEVAR was performed in 3% (n = 2) of ABF patients and in 37% (n = 16) of AEF patients (p<0.001); 12 AEF patients who had received esophageal surgery in the first month after TEVAR showed lower fistula-related mortality during 6 months of follow-up compared to patients who did not receive additional esophageal surgery (p = 0.018). CONCLUSION TEVAR is associated with superior outcomes in patients with ABF. Endovascular management of AEF is associated with poor results and should not be considered definitive treatment. TEVAR could serve as a bridge to surgery for emergency cases of AEF only, with definitive open surgical correction of the fistula undertaken as soon as possible.
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Affiliation(s)
- Frederik H W Jonker
- Department of Surgery and Radiology, Yale University School of Medicine, New Haven, Connecticut, USA
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Riesenman PJ, Brooks JD, Farber MA. Thoracic endovascular aortic repair of aortobronchial fistulas. J Vasc Surg 2009; 50:992-8. [DOI: 10.1016/j.jvs.2009.03.001] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Revised: 03/05/2009] [Accepted: 03/06/2009] [Indexed: 11/27/2022]
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Jonker FHW, Heijmen R, Trimarchi S, Verhagen HJM, Moll FL, Muhs BE. Acute management of aortobronchial and aortoesophageal fistulas using thoracic endovascular aortic repair. J Vasc Surg 2009; 50:999-1004. [PMID: 19481408 DOI: 10.1016/j.jvs.2009.04.043] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2009] [Revised: 04/10/2009] [Accepted: 04/17/2009] [Indexed: 11/16/2022]
Affiliation(s)
- Frederik H W Jonker
- Section of Vascular Surgery, Department of Surgery at Yale University School of Medicine, New Haven, CT 06510, USA
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Samano MN, Saka JA, Caramori ML, Pêgo-Fernandes PM, Jatene FB. Fatal bronchovascular fistula after a single lung transplantation: a case report. Clinics (Sao Paulo) 2009; 64:1031-3. [PMID: 19841712 PMCID: PMC2763063 DOI: 10.1590/s1807-59322009001000015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Marcos Naoyuki Samano
- Thoracic Surgery Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil
| | - Juliana Akemi Saka
- Thoracic Surgery Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil
| | - Marlova Luzzi Caramori
- Pulmonology Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil., , Tel.: 55 113069.5248
| | - Paulo Manuel Pêgo-Fernandes
- Thoracic Surgery Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil
| | - Fabio Biscegli Jatene
- Thoracic Surgery Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo - São Paulo/SP, Brazil
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Wheatley GH, Nunez A, Preventza O, Ramaiah VG, Rodriguez-Lopez JA, Williams J, Olsen D, Diethrich EB. Have we gone too far? Endovascular stent-graft repair of aortobronchial fistulas. J Thorac Cardiovasc Surg 2007; 133:1277-85. [PMID: 17467441 DOI: 10.1016/j.jtcvs.2006.11.066] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Revised: 10/27/2006] [Accepted: 11/06/2006] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Although endovascular repair of the descending thoracic aorta has emerged as a viable treatment option, little is known about its potential to treat patients diagnosed with aortobronchial fistulas. We reviewed our comprehensive thoracic endografting experience with regard to the endovascular management and subsequent outcome of patients with aortobronchial fistulas to assess whether endoluminal graft repair is a realistic option. METHODS Between February 2000 and November 2005, 255 patients were successfully treated with an endoluminal graft to the descending thoracic aorta. Indications for intervention included: atherosclerotic aneurysms (109/255, 42.7%), acute and chronic dissections (75/255, 29.4%), miscellaneous (34/255, 13.3%), penetrating aortic ulcers (30/255, 11.8%), and aortobronchial fistulas (7/255, 2.7%). RESULTS Average patient age was 73.4 +/- 10.1 years, with 4 male patients (4/7, 57.1%) and 3 female patients (3/7, 42.9%). All patients presented with hemoptysis, with 1 patient (1/7, 14.3%) requiring preoperative blood transfusion. Three patients (3/7, 42.9%) were diagnosed with atherosclerotic aneurysms, 3 patients (3/7, 42.9%) had pseudoaneurysms associated with prior open surgical repair, and 1 patient (1/7, 14.3%) had a prior endoluminal graft placed for a traumatic aortic transection. No standard postoperative antibiotic regimen was followed. There were no endoleaks, no incidences of paraplegia, and no endoluminal graft infections. Survival was 100% (7/7) at both 30 days and 1 year, and all patients are currently alive. Follow-up computed tomography was available for all 7 patients, with an average follow-up of 42.6 +/- 28.5 months. CONCLUSIONS Endovascular management of aortobronchial fistulas appears to be safe and well tolerated, even in surgically high-risk patients, with minimal risk of prosthesis infection. Long-term surveillance and continued investigation are warranted.
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Affiliation(s)
- Grayson H Wheatley
- Department of Cardiovascular and Endovascular Surgery, Arizona Heart Institute, Phoenix, Ariz 85006, USA.
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Picichè M, Demaria RG, Albat B. Endovascular repair of postoperative aortobronchopulmonary fistulas. J Thorac Cardiovasc Surg 2007; 133:1125. [PMID: 17382688 DOI: 10.1016/j.jtcvs.2006.10.077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2006] [Accepted: 10/25/2006] [Indexed: 10/23/2022]
Affiliation(s)
- Marco Picichè
- Service de Chirurgie Cardio-Vasculaire, Chu Arnaud de Villeneuve, Montpellier, France
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22
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Ishibashi H, Ohta T, Sugimoto I, Kawanishi J, Yamada T, Ishiguchi T, Io A. Successful Treatment of an Aorto-Ileal-Conduit Fistula with an Endovascular Stent Graft: Report of a Case. Surg Today 2007; 37:305-7. [PMID: 17387562 DOI: 10.1007/s00595-006-3402-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2006] [Accepted: 11/11/2006] [Indexed: 10/23/2022]
Abstract
A 55-year-old man presented with a massive hemorrhage from the ileal conduit of the left ureter. He had previously undergone a total pelvic exenteration with ileal conduit construction of the ureters due to rectal carcinoma. A right ureteroarterial fistula developed, and he underwent an excision of the right common iliac artery with a femorofemoral bypass and a right cutaneous ureterostomy. Seven months later, a pseudoaneurysm developed at the aortic stump, followed by an aorto-ileal-conduit fistula. The patient was treated successfully with endovascular stent grafting and has since showed a good recovery no sign of graft infection or a recurrence of hematuria at the 10-month follow-up.
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Affiliation(s)
- Hiroyuki Ishibashi
- Department of Vascular Surgery, Aichi Medical University, Nagakute, Aichi, 480-1195, Japan
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23
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Sánchez I, Escudero-Rodríguez J, Orellana-Fernández G, Dilmé-Muñoz J, Surcel P, Davins-Riu M, Romero-Carro J, Sirvent González M. Tratamiento endovascular de la patología aórtica excepcional. ANGIOLOGIA 2006. [DOI: 10.1016/s0003-3170(06)75005-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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24
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Munneke G, Loosemore T, Smith J, Thompson M, Morgan R, Belli AM. Pseudoaneurysm after aortic coarctation repair presenting with an aortobronchial fistula successfully treated with an aortic stent graft. Clin Radiol 2006; 61:104-8. [PMID: 16356824 DOI: 10.1016/j.crad.2005.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2005] [Revised: 07/04/2005] [Accepted: 07/07/2005] [Indexed: 11/21/2022]
Affiliation(s)
- G Munneke
- Department of Interventional Radiology, St George's Hospital, London, UK.
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25
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Algaba Calderón A, Jara Chinarro B, Abad Fernández A, Isidoro Navarrete O, Ramos Martos A, Juretschke Moragues MA. [Recurrent hemoptysis secondary to an aortobronchial fistula]. Arch Bronconeumol 2005; 41:352-4. [PMID: 15989894 DOI: 10.1016/s1579-2129(06)60236-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aortobronchial fistula is a rare but serious cause of hemoptysis. It can develop from an aneurysm of the descending thoracic aorta in the context of infections or it may appear as a sequel of surgical repair of congenital heart defects. Presenting symptoms include mild bronchial hemorrhages and recurrent chest pain, culminating in a normally fatal massive hemorrhage. Diagnosis by imaging is not always conclusive and clinical suspicion based on medical history is essential. Surgical placement of an endovascular stent graft is the treatment of choice. Post-surgical prognosis is good although there is a risk of recurrence in the case of superinfection.
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Affiliation(s)
- A Algaba Calderón
- Servicio de Cuidados Intensivos, Hospital Universitario de Getafe, Getafe, Madrid, Spain
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26
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Algaba Calderón A, Jara Chinarro B, Abad Fernández A, Isidoro Navarrete O, Ramos Martos A, Juretschke Moragues M. Hemoptisis recurrente secundaria a una fístula aortobronquial. Arch Bronconeumol 2005. [DOI: 10.1157/13076005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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Clarot C, Leleu O, Touati G, Reix T, Jounieaux V. [Aortobronchial fistulas]. Rev Mal Respir 2004; 21:943-9. [PMID: 15622341 DOI: 10.1016/s0761-8425(04)71476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION Aortobronchial fistulas are uncommon but generally fatal if not treated surgically. Haemoptysis is the main symptom of this pathology. STATES OF ART AND PERSPECTIVES: Aortobronchial fistulas occur most commonly in patients with thoracic aneurysms (atherosclerosis, mycotic, aortic surgery's complication...). Main investigation is CT angiography with 2 D and 3 D reconstructions. CONCLUSION Endovascular exclusion can be efficient treatment option.
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Affiliation(s)
- C Clarot
- Service Pneumologie, CH Abbeville, Abbeville, France
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28
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Böckler D, Schumacher H, Schwarzbach M, Ockert S, Rotert H, Allenberg JR. Endoluminal Stent-Graft Repair of Aortobronchial Fistulas:Bridging or Definitive Long-term Solution? J Endovasc Ther 2004. [DOI: 10.1583/1545-1550(2004)011<0041:esroaf>2.0.co;2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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29
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Dilmé-Muñoz J, Escudero-Rodríguez J, Llauger-Roselló J, García-Moll Marimón X, Barreirro-Veiguela J, Viver-Manresa E. Exclusión endoprotésica de fístula aortobronquial con hemoptisis. ANGIOLOGIA 2003. [DOI: 10.1016/s0003-3170(03)74834-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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