Three patients after cardiovascular surgery developed severe esophageal bleeding. All had been diagnosed as having an aberrant subclavian artery (ASCA). ASCA is the commonest congenital anomaly of the aortic arch, which arises from the proximal portion of the descending thoracic aorta and runs across the back side of the esophagus. The patients were intubated with a tracheal, nasogastric or ileus tube for a long time after surgery because of low output syndrome (LOS), delayed awareness, or ileus. The ASCA was compressed by the nasogastric or ileus tube in the esophagus and the patients developed an ASCA-esophageal fistula and bleeding. It should be noted that patients with an ASCA may suffer from esophageal bleeding due to the prolonged use of a nasogastric tube. Prevention is the best way to avoid this serious complication.
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