Korean J Thorac Cardiovasc Surg.  2017 Aug;50(4):287-290. 10.5090/kjtcs.2017.50.4.287.

Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair

• Sica G
• Rea G
• Bocchini G
• Lombardi R
• Muto M
• Valente T

• KMID: 2387916
• DOI: http://doi.org/10.5090/kjtcs.2017.50.4.287

Abstract

Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications. Further, the effectiveness and modality of prolonged antibiotic prophylaxis and/or preoperative respiratory physiotherapy should be assessed in such cases.

Keyword

Endovascular procedures; Aortic aneurysm; Pulmonary atelectasis; Complication; Physiotherapy

MeSH Terms

Aneurysm
Antibiotic Prophylaxis
Aorta, Thoracic
Aortic Aneurysm
Diabetes Mellitus
Endoleak*
Endovascular Procedures
Fistula*
Hemoptysis
Humans
Hypertension
Middle Aged
Pulmonary Atelectasis
Tomography, X-Ray Computed