Successful treatment of aortoesophageal fistula resulting from aneurysm of the aortic arch.

Aortoesophageal fistulas from primary thoracic aortic aneurysms are almost always fatal. In the English literature we have found only four successfully managed cases, all descending thoracic aortic aneurysms. We report an elderly woman who developed an aortoesophageal fistula from an aortic arch aneurysm. She was successfully managed with graft replacement including reattachment of arch vessels and a staged esophagectomy which was accompanied by mobilization of the omentum into the space between the esophagus and the prosthetic graft. She was the first successfully treated patient with aortoesophageal fistula resulting from aortic arch aneurysm.