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Aortoesophageal fistula involving the central aortic arch salvaged with emergent percutaneous TEVAR great vessel coverage and in vivo graft fenestration

机译:Aortoesophageal瘘涉及中央主动脉曲拱挽救出突然经皮Tevar巨大的船舶覆盖范围和体内移植术

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摘要

Immediate intervention is needed for aortoesophageal fistulas (AEF), a rare but highly lethal cause of massive gastrointestinal hemorrhage. Emergent thoracic endovascular aortic repair (TEVAR) is considered first-line treatment for massive bleeding from AEFs. We describe an unusual and challenging case of TEVAR coverage of an AEF involving the central aortic arch immediately followed by in vivo endograft fenestration to regain arch vessel perfusion. In vivo fenestration, currently a procedure for emergency or investigational purposes only, was shown to be life saving in our case. The main complications associated with the procedure included stroke and infection, requiring esophagectomy and cervical diversion as well as ongoing antibiotic treatment.
机译:Aortoesophageal Fustulas(牛肉)需要立即干预,罕见但高度致命的大规模胃肠道出血。紧急胸腔血管内主动脉修复(TEVAR)被认为是从AEFS大规模出血的初线处理。我们描述了涉及中央主动脉弓的AEF的Tevar覆盖的一个不寻常和具有挑战性的案例,然后在体内内血曲线中恢复拱血管灌注。在体内失败中,目前只有紧急或调查目的的程序被证明是我们的案件中的救生。与该程序相关的主要并发症包括中风和感染,需要食管切除术和宫颈转移以及持续的抗生素治疗。

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