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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672711PMC
http://dx.doi.org/10.5114/pg.2017.70476DOI Listing

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Rationale: Aortoesophageal fistula (AEF) is an exceedingly rare yet critically life-threatening condition, with mortality rates nearing 100% if not addressed promptly. AEF often develops in the context of thoracic aortic aneurysms, esophageal malignancies, or as a complication of foreign body ingestion and prior thoracic aortic surgeries. This study reports an exceptionally severe and clinically rare case of AEF associated with a pseudaneurysm induced by esophageal stenting.

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Single-Stage Surgical Approach to Aortoesophageal Fistula After Thoracic Endovascular Aortic Repair.

Ann Thorac Surg Short Rep

September 2024

Department of Cardiovascular Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China.

Background: The aortoesophageal fistula (AEF) caused by thoracic endovascular aortic repair is a challenging condition. Traditional treatment approaches have been associated with high mortality and morbidity. This study introduces a modified single-stage surgical strategy that aims to optimize outcomes and to reduce the risk of recurrence for AEF.

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Objective: Aorto-esophageal fistula (AEF) is a rare condition consisting in a fistula between the aorta and the esophagus. The thoracic endovascular aortic repair (TEVAR) has become an accepted treatment for initial AEF management, but large series are not available and outcomes are questionable. This study aims at evaluating the current evidence of TEVAR in AEF.

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Article Synopsis
  • Aortoesophageal fistulas (AEFs) are serious complications from thoracic aortic aneurysms that lead to high mortality due to massive upper gastrointestinal bleeding.
  • A 46-year-old patient with an infected thoracic aortic aneurysm developed an AEF, prompting emergency surgery and the use of a Foley catheter to temporarily control bleeding.
  • The use of the Foley catheter was crucial for stabilizing the patient and allowed for further intensive care management to address ongoing complications.
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Article Synopsis
  • A study analyzing the surgical treatment of aortoesophageal fistula (AEF) from 2020 to 2021 in Japan revealed that 61% of cases were secondary AEF, often arising from previous aortic surgeries.
  • Among 123 patients, the operative mortality rate was 18.7%, with significant factors contributing to mortality including postoperative complications like bleeding, stroke, and pneumonia.
  • The findings highlight the need for improved treatment strategies for AEF, as both surgical methods (open repair and TEVAR) were linked to high mortality rates and specific risk factors like dyslipidemia.
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