Aortoesophageal fistula following TEVAR: Celerity of a multidisciplinary approach and its prognostic implications

• Autor(a) principal: Henrique,Alberto
• Data de Publicação: 2022
• Outros Autores: Quintas,Anita, Morais,José Aragão, Martins,Francisco Oliveira, Garcia,Rita, Bento,Rita, Pais,Fábio, Ferreira,Maria Emília
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-706X2022000400245
• topic: Aortic aneurysm; endovascular; graft infection; aortoesophageal fistula; thoracic aorta

Abstract Introduction: Secondary Aortoesophageal fistula (AEF) is a rare but serious complication following thoracic endovascular aneurysm repair (TEVAR), which may lead to fatal outcomes. Case report: We present the case of a 62-year-old patient developing a secondary AEF one-month after TEVAR. The patient was managed in a staged approach: first, an oesophagus defunctionalisation by cervical oesophagus stapling, followed by drainage gastrostomy and creation of a feeding jejunostomy. Two-weeks later, the patient underwent stent graft explantation, extensive debridement, in situ aortic reconstruction with interposition of a silver and Triclosan impregnated Dacron graft, esophagectomy, eosophagogastrostomy and intercostal muscle flap plasty. After 4 years of follow-up, the patient remains clinically well and free from recurrence. Conclusion: The diagnosis of AEF requires a high index of suspicion. A prompt and aggressive multidisciplinary approach is necessary to obtain long-term survival and freedom from recurrence.