Surgical Management for Aortoesophageal Fistula After Endovascular Aortic Repair

Abstract

This case demonstrates successful surgical management of a 6-cm-long aortoesophageal fistula from an infected stent graft. A 69-year-old woman with a penetrating descending thoracic aortic ulcer underwent endovascular aortic repair. Two weeks later, she presented with nausea and melena, and she was found to have an infected stent graft on imaging. She underwent a two-stage procedure encompassing aortic arch debranching and extra-anatomic aortic bypass in stage 1, and stent graft resection, primary esophageal repair, intercostal and omental flap, and jejunostomy tube placement in stage 2. She was discharged 1 month later and is doing well 1.5 years after the operation.