Меню

New method of performing operation for thoracic aortic aneurysm complicated by primary aortoesophageal fistula

Abstract

Presented herein is a new method of the operation for a thoracic aortic aneurysm complicated by an aortoesophageal fistula and hemorrhage. The technology of performing the procedure was aimed first of all at preventing mediastinitis. The patient underwent prosthetic repair of the thoracic artery with reduction of the aneurysmal sac in the zone of the aortoesophageal fistula according to the developed technique, with no surgical manipulations performed on the esophagus. On POD 16, sutures were removed, with the patient discharged in a satisfactory condition. There was no evidence of esophageal dysfunction. A total of 3 patients were operated on according to the presented technology.

Keywords:aortic aneurysm; thoracic aortic aneurysm; aortoesophageal fistula; aortic prosthetic repair

Funding. The study had no financial support.

Conflict of interest. The authors declare no conflicts of interest.

Authors’ contribution. Study conception and design – Vachev A.N.; data collection and handling – Vachev A.N., Chernovalov D.A.; statistical processing – Chernovalov D.A.; draft manuscript preparation – Chernovalov D.A.; manuscript revision – Vachev A.N.

For citation: Vachev A.N., Chernovalov D.A. New method of performing operation for thoracic aortic aneurysm complicated by primary aortoesophageal fistula. Angiology and Vascular Surgery. 2023; 29 (1): 115–9. DOI: https://doi.org/10.33029/1027-6661-2022-29-1-115-119 (in Russian)

References

1. Hollander J.E., Quick G. Aortoesophageal fistula: a comprehensive review of the literature. American Journal of Medicine. 1991; 91 (3): 279–287. DOI: https://doi.org/10.1016/0002-9343(91)90129-l

2. Burks J.A. Jr., Faries P.L., Gravereaux E.C., et al. Endovascular repair of bleeding aortoenteric fistulas: a 5-year experience. Journal of Vascular Surgery. 2001; 34 (6): 1055–1059. DOI: https://doi.org/10.1067/mva.2001.119752

3. Kieffer E., Chiche L., Gomes D. Aortoesophageal fistula: value of in situ aortic allograft replacement. Annals of Surgery. 2003; 238 (2): 283–290. DOI: https://doi.org/10.1097/01.sla.0000080828.37493.e0

4. Flores J., Shiiya N., Kunihara T., et al. Aortoesophageal fistula: alternatives of treatment case report and literature review. Annals of Thoracic and Cardiovascular Surgery. 2004; 10 (4): 241–246.

5. Kubota S., Shiiya N., Shingu Y., et al. Surgical strategy for aortoesophageal fistula in the endovascular era. General Thoracic and Cardiovascular Surgery. 2013; 61 (10): 560–564. DOI: https://doi.org/10.1007/s11748-013-0280-y

6. Canaud L., Ozdemir B.A., Bee W.W., et al. Thoracic endovascular aortic repair in management of aortoesophageal fistulas. Journal of Vascular Surgery. 2014; 59 (1): 248–254. DOI: https://doi.org/10.1016/j.jvs.2013.07.117

7. Akashi H., Kawamoto S., Saiki Y., et al. Therapeutic strategy for treating aortoesophageal fistulas. General Thoracic and Cardiovascular Surgery. 2014; 62 (10): 573–580. DOI: https://doi.org/10.1007/s11748-014-0452-4

8. Popova I.E., Danielyan SH.N., Pogodina A.N., et al. Peculiarities of diagnosis and emergency surgical care in aorto-oesophageal fistula. Angiology and Vascular Surgery. 2020; 26 (3): 108–114. DOI: https://doi.org/10.33529/ANGIQ2020303 (in Russian)

9. Chen C., Kim J.W., Shin J.H., et al. Management of life-threatening aortoesophageal fistula: experiences learned from eight patients. Acta Radiologica. 2021; 62 (4): 447–452. DOI: https://doi.org/10.1177/0284185120933228

10. Zhong X.Q., Li G.X. Successful management of life-threatening aortoesophageal fistula: A case report and review of the literature. World Journal of Clinical Cases. 2022; 10 (12): 3814–3821. DOI: https://doi.org/10.12998/wjcc.v10.i12.3814

11. Leonhardt H., Mellander S., Snygg J., Lönn L. Endovascular management of acute bleeding arterioenteric fistulas. Cardiovascular and Interventional Radiology. 2008; 31 (3): 542–549. DOI: https://doi.org/10.1007/s00270-007-9267-3

12. Ivanov A.I., Popov V.A., Burmistrov M.V. Endoscopic stenting of esophageal perforations. Endoscopic Surgery. 2021; 27 (3): 48–54. DOI: https://doi.org/10.17116/endoskop20212703148 (in Russian)

13. Le´obon B., Roux D., Mugniot A., et al. Endovascular treatment of thoracic aortic fistulas. Annals of Thoracic Surgery. 2002; 74 (1): 247–249. DOI: https://doi.org/10.1016/s0003-4975(02)03466-5

14. Topel I., Stehr A., Steinbauer M.G., et al. Surgical strategy in aortoesophageal fistulae: endovascular stentgrafts and in situ repair of the aorta with cryopreserved homografts. Annals of Surgery. 2007; 246 (5): 853–859. DOI: https://doi.org/10.1097/SLA.0b013e3180caa3c9

15. Gonza´lez–Fajardo J.A., Gutie´rrez V., Martı´n-Pedrosa M., et al. Endovascular repair in the presence of aortic infection. Annals of Vascular Surgery. 2005; 19 (1): 94–98. DOI: https://doi.org/10.1007/s10016-004-0144-0

16. Takeno S., Ishii H., Nanashima A., Nakamura K. Aortoesophageal fistula: review of trends in the last decade. Surgery Today. 2020; 50 (12): 1551–1559. DOI: https://doi.org/10.1007/s00595-019-01937-z

Akchurin Renat Suleymanovich

Doctor of Medical Sciences, Professor, Academician of the Russian Academy of Sciences, Deputy General Director for Surgery, Head of the Department of Cardiovascular Surgery, National Medical Research Center for Cardiology named after Academician E.I. Chazov, President of the Russian Society of Angiologists and Vascular Surgeons

In accordance with the decision of the Presidium of the Russian Society of Angiologists and Vascular Surgeons, the journal "Angiology and Vascular Surgery" will be named after Academician A.V. Pokrovsky starting from No. 2/2022.