Emergency treatment for aorto-esophageal fistula by endovascular aortic repair / 中华胸心血管外科杂志

ABSTRACT

Objective To investigate the clinical features,essentials of diagnosis,selection of endovascular treatment and prognosis of aorto-esophageal fistula(AEF).To improve the understanding of the disease.Methods 3 patients with AEF from October 2010 to July 2016 in Changhai Hospital,including clinical symptoms and signs,endovascular treatment process and follow-up results,and review the relevant literature.Results Two of the 3 patients are men,and another is a woman.Aged 64-70 years.The causes of AEF are chest trauma,thoracic aorta pseudoaneurysms and foreign body ingestion,respectively.All the 3 patients had chest pain,hematemesis,and fever.Two of them showed sentinel hemorrhage and another showed a sudden massive hematemesis.Upper gastrointestinal endoscopy or computed tomographic angiography (CTA) confirmed the diagnosis in all patients.They all underwent thoracic endovascular aortic repair(TEVAR).The effect was good in acute phase.It didn't have any significant short-term complications.Re-bleeding time was 35 days to 85 days.Two patients died of recurrent severe hemorrhage post operation,and one of them had received TEVAR again but not it was ineffective.Another died of multiple organ failure after open surgery.Conclusion Since it showed the short-term effect but not the long-term effect,TEVAR can only be applied as a temporary remedy to the patients in poor conditions and be substituted by the open surgery when the patients were in better conditions.