Postoperative aortic fistulas into the airways: etiology, pathogenesis, presentation, diagnosis, and management

Picichè, Marco; Paulis, Ruggero De; Fabbri, Alessandro; Chiariello, Luigi

doi:10.1016/s0003-4975(02)04837-3

Cited by 116 publications

(115 citation statements)

References 62 publications

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“…Angiography or bronchoscopy may demonstrate a fistula but must be performed with extreme caution, because the procedure could potentially dislodge a clot overlying a fistula and induce massive, possibly fatal hemorrhage. 213,259,260 A high index of suspicion is vital for an accurate and prompt diagnosis of aortobronchial fistula.…”

Section: Additional Factors In Management Of Aortic Mamentioning

confidence: 99%

“…213,257 The high mortality rate associated with in situ repair is related to thoracotomy in a critically ill patient, cross-clamping of the descending aorta with possible spinal cord injury or reperfusion injury, and complications including rupture from in situ repair or attempts at arterial bypass. 213,257,259 Chuter et al 261 first reported thoracic endovascular aortic repair (TEVAR) in 1996. Bailey et al 257 reported 11 patients with TEVAR, which represents the largest series of patients treated with TEVAR for aortobronchial fistula.…”

Section: Additional Factors In Management Of Aortic Mamentioning

confidence: 99%

See 1 more Smart Citation

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

355

307

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The use of synthetic material for reconstructive vascular surgery was first reported during the early 1950s. Infection involving vascular graft prostheses is an infrequent but devastating complication of reconstructive vascular graft surgery and is associated with a high morbidity and, in some situations, mortality. Improvements in surgical techniques and graft design, including the use of native venous or arterial tissue, have reduced the frequency of infection and severity of complications from vascular graft infection (VGI). However, these advances have also led to more frequent vascular graft procedures occurring in a patient population with multiple underlying comorbidities that would have previously disqualified them as candidates for vascular reconstructive surgery. Underlying comorbidities, such as diabetes mellitus or immune compromise, increase the risk of infection and serious infection-related complications. The major complications of VGI include sepsis, amputation, disruption of infected anastomotic suture line with rupture or pseudoaneurysm formation, embolization of infected thrombi, reinfection of reconstructed vascular grafts, enteric fistulae to the small or large bowel, bacteremic spread of infection to other sites, and death. VGIs can be categorized broadly into those that occur in an extracavitary location, primarily in the groin or lower extremities, or in an intracavitary location, primarily within the abdomen or less commonly within the thorax. frequencyThe frequency of VGI depends on the anatomic location of the graft. The infection rate is 1.5% to 2% for most extracavitary grafts and as high as 6% with vascular grafts in the groin. [1][2][3][4][5][6][7][8][9] For intracavitary grafts, the infection rate is ≈1% to 5%. 1-6 Graft infection is most common after emergency procedures and after reoperation. [1][2][3][4]10 Aortic graft erosion or fistulous communication into the duodenum or other areas of the bowel reportedly occurs in 1% to 2% of patients after aortic reconstruction. 11,12 MicrobiologyThe microbiological cause of VGI has evolved over the years. 1 In early published studies, Staphylococcus aureus was the predominant microorganism recovered. 1,13 Improvements in surgical technique, administration of prophylactic antistaphylococcal antimicrobial therapy, and other factors have resulted in a changing microbiological epidemiology. Vascular graft surgery performed on patients with multiple underlying comorbidities and the increased frequency of emergency procedures have contributed to the changing spectrum of infection. Other factors such as changes in hospital flora, surgery in patients with complicated vascular anatomy, and multiple revisions of previous vascular surgery have resulted in a more diverse microbio- clInIcal stateMents anD GuIDelInes logical spectrum of infection, which includes multidrugresistant strains, polymicrobial infection, and Candida species. Gram-positive cocci accounts for at least two thirds of VGIs. 1,13 Infections caused by coagulase-negative staphylococ...

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Section: Additional Factors In Management Of Aortic Mamentioning

confidence: 99%

Section: Additional Factors In Management Of Aortic Mamentioning

confidence: 99%

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Wilson¹,

Bower²,

Creager³

et al. 2016

Circulation

355

307

View full text Add to dashboard Cite

show abstract

“…Open surgery entails high morbidity and mortality, and mortality rates range from 25% to 60% (Thompson et al, 2002;Piciche et al, 2003;Liu et al, 2004). As regards endovascular repair of aortobronchial fistula, a review of the literature revealed less than 60 cases treated using endovascular repair.…”

Section: Discussionmentioning

confidence: 99%

Endovascular Repair of Thoracic Aortic Emergencies

Ribé¹,

Portero²,

Solis³

et al. 2011

Diagnosis and Treatment of Abdominal and Thoracic Aortic Aneurysms Including the Ascending Aorta and the Aortic Arch

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“…12 Bizim olgumuzda da operasyondan 27 ay sonra başlayan ve tekrarlayan hemoptizi mevcuttu. ABF'nin %86'sı desenden aort ve sol trakeobronşiyal sistem arasında meydana gelir.…”

Section: Olgu Sunumuunclassified

An Interesting Case of Hemoptysis: Aorta-Bronchial Fistula Caused by Spinal Fixation Device

Acar¹,

Fındık²,

Gülhan³

et al. 2015

Turkiye Klinikleri Arch Lung

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Postoperative aortic fistulas into the airways: etiology, pathogenesis, presentation, diagnosis, and management

Cited by 116 publications

References 62 publications

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Vascular Graft Infections, Mycotic Aneurysms, and Endovascular Infections: A Scientific Statement From the American Heart Association

Endovascular Repair of Thoracic Aortic Emergencies

An Interesting Case of Hemoptysis: Aorta-Bronchial Fistula Caused by Spinal Fixation Device

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