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Aortobronchial fistula late after transverse arch replacement
M Ono1, S Takamoto, M Kawauchi
1Department of Cardiothoracic Surgery, University of Tokyo, Japan.
The Annals of Thoracic Surgery
|October 4, 2000
Summary
A rare aortobronchial fistula developed years after aortic arch surgery due to a misplaced bypass graft remnant. Proper placement and tailoring of bypass side branches are crucial to prevent serious late complications in aortic reconstructive surgery.
Area of Science:
- Cardiovascular Surgery
- Thoracic Surgery
- Medical Case Reports
Background:
- Aortic arch replacement is a complex procedure.
- Antegrade perfusion via a side branch is a surgical technique used in ascending aorta reconstruction.
- Potential complications of aortic surgery require careful consideration.
Observation:
- An unusual aortobronchial fistula was observed.
- The fistula occurred late after transverse aortic arch replacement.
- The cause was identified as a remnant of a temporary bypass graft near the ascending aorta.
Findings:
- A remnant bypass graft side branch near the ascending aorta can lead to aortobronchial fistula.
- Improper placement or tailoring of the side branch poses a significant risk.
- This complication can manifest as a serious late event after aortic reconstructive surgery.
Implications:
- Highlights a potential iatrogenic risk in aortic arch surgery.
- Emphasizes the importance of meticulous surgical technique in placing bypass graft side branches.
- Suggests a need for careful evaluation of graft remnants in patients presenting with late complications after aortic surgery.