Surgical strategy for the treatment of aortoesophageal fistula

Abstract

Although a comparative study was not performed, 1-stage surgery consisting of resection of an aneurysm and esophagus, in situ reconstruction of the descending aorta, and omental flap installation provided a better outcome in the treatment for AEF. Bridging TEVAR to the open surgery is a useful adjunct in patients with AEF with hemorrhagic shock. Later reconstruction of the esophagus can be performed in the survivors.

Predictable or fateful—a short guide for how to anticipate risk to keep the incidence of aortoesophageal fistulation to a minimum

“…This process is rarely an acute one but occurs slowly, with a median duration of 3 months between the acute event and AEF formation, according to the European Registry of Endovascular Complications after TEVAR, and may even take longer, as reported here. 1,2 What this study nicely shows, thereby confirming previous reports, is that the pattern behind AEF formation seems to be largely consistent. Let us focus on diameter and aortic tissue behavior after TEVAR.…”

Hemorrhagic Shock Secondary to Aortoesophageal Fistula as a Complication of Esophageal Cancer

“…Primary repair of the esophageal defect could result in positive progression, particularly in small lesions detected early [15]. Nonetheless, better outcomes are obtained with esophagectomy, removal of the devitalized tissue, in situ restoration of the aorta with a synthetic prosthesis, and protection with a viable pedicle flap of the omentum, pleura, or adventitia [9,[16][17]. Depending on the cause, diversion surgery can also be necessary.…”

Successful Surgical Strategy for Graft-esophageal Fistula After Total Arch Replacement : A Case Report.

“…Several options for aorto-esophageal connection disease have recently been described in the literature (9,10). Bridged thoracic endovascular aneurysm repair (TEVAR) enables rapid control of bleeding and is less invasive than traditional surgery.…”