surgical management of aorto-esophageal fistula as a late complication after graft replacement for acute aortic dissection
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2016
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Abstract
A 49-year-old male presented with chills and a fever. Five years previously, he underwent ascending aorta and
aortic arch replacement using the elephant trunk technique for DeBakey type 1 aortic dissection. The preoperative
evaluation found an esophago-paraprosthetic fistula between the prosthetic graft and the esophagus. Multiple-stage
surgery was performed with appropriate antibiotic and antifungal management. First, we performed esophageal exclusion
and drainage of the perigraft abscess. Second, we removed the previous graft, debrided the abscess, and
performed an in situ re-replacement of the ascending aorta, aortic arch, and proximal descending thoracic aorta,
with separate replacement of the innominate artery, left common carotid artery, and extra-anatomical bypass of the
left subclavian artery. Finally, staged esophageal reconstruction was performed via transthoracic anastomosis. The
patient’s postoperative course was unremarkable and the patient has done well without dietary problems or recurrent
infections over one and a half years of follow-up.
| Reference Key |
lee2016koreansurgical
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| Authors | ;Jae-Hong Lee;Bubse Na;Yoohwa Hwang;Yong Han Kim;In Kyu Park;Kyung-Hwan Kim |
| Journal | health promotion international |
| Year | 2016 |
| DOI |
10.5090/kjtcs.2016.49.1.54
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