Aorto-cutaneous fistula of the ascending aorta-case report and a literature review of endovascular management

Sinead Gormley; Zubayr Zaman; Kevin Mani; Manar Khashram

doi:10.1016/j.jvscit.2022.06.023

Aorto-cutaneous fistula of the ascending aorta-case report and a literature review of endovascular management

J Vasc Surg Cases Innov Tech. 2022 Jul 30;9(1):100971. doi: 10.1016/j.jvscit.2022.06.023. eCollection 2023 Mar.

Authors

Sinead Gormley^{1

2}, Zubayr Zaman³, Kevin Mani^{1

4

5}, Manar Khashram^{1

4}

Affiliations

¹ Department of Vascular & Endovascular Surgery, Waikato Hospital Hamilton, Hamilton, New Zealand.
² Faculty of Medicine, University of Auckland, Auckland, New Zealand.
³ Department of Interventional Radiology, Waikato Hospital Hamilton, Hamilton, New Zealand.
⁴ Department of Surgery, University of Auckland, Auckland, New Zealand.
⁵ Department of Surgical Sciences, Section of Vascular Surgery, Uppsala University, Uppsala, Sweden.

Abstract

Aorto-cutaneous fistulas are an unusual and life-threatening complication after aortic surgery. We present the case of an endovascular intervention for an aorto-cutaneous fistula of the ascending aorta that was intended to be a bridge to definitive surgical treatment and report a literature review. A 56-year-old woman had a previous Bentall's procedure and mitral valve annuloplasty in 2016. Four years later she re-presented with an infective pseudoaneurysm of the distal anastomosis of the ascending aortic graft, with aorto-cutaneous fistulation. She was at high risk for a revision operation and required optimization before a major open surgery. A thoracic endovascular aortic repair stent graft (Valiant Navion; Medtronic Inc) was implanted to exclude the distal anastomotic pseudoaneurysm. Two months later she re-presented with a new infected pseudoaneurysm at the proximal end of the previously implanted stent graft, and a further thoracic endovascular aortic repair was undertaken.

Keywords: Aortic pseudoaneurysm; Aorto-cutaneous fistula; Ascending aorta; Case report; Endovascular treatment; TEVAR.

Publication types

Case Reports