Two-stage safe repair of aortobronchial fistula

Aortobronchial fistulas are a rare and frequently misdiagnosed cause of massive hemoptysis, which is often fatal. Aortic stent grafts now allow for a safer emergency repair. However, there is a high (40% to 50%) recurrence risk, with a high fatality rate. A patient with an aortobronchial fistula due to a ruptured thoracic aortic aneurysm underwent a two-stage repair. An aortic stent graft was deployed as an emergency, and a second surgical durable repair was performed 4 months later. The patient recovered well. The best management of aortobronchial fistula may be emergency use of stent graft, followed by a delayed durable open repair when the patient has achieved stability.