Open stent-grafting for an aortobronchial fistula

A 78-year-old woman was admitted to our hospital with intermittent hemoptysis. She had undergone descending aortic replacement through a left thoracotomy 7 years previously. Enhanced computed tomography revealed a pseudoaneurysm at the proximal suture line in the descending aorta and an ascending aortic aneurysm. Bronchoscope revealed bleeding from the left lower bronchus. Ascending and total aortic arch replacement and simultaneous open stent-graft placement into the descending aorta were performed through a median sternotomy. Selective antegrade cerebral perfusion and moderate hypothermia were used during these procedures. The postoperative course was favorable. Open stent-graft placement is a good alternative for treating aortobronchial fistula caused by suture line pseudoaneurysm in the descending aorta.