Secondary Aortopulmonary Fistula After Thoracic Endovascular Aortic Repair: Case Report

Aortopulmonary fistula is a rare but serious condition associated with high mortality, primarily observed in specific patient groups, including those with prior placement of aortic endografts. Its incidence has risen with the adoption of endovascular techniques like thoracic endovascular aortic repair, which, despite its benefits, may lead to complications such as aortobronchial and aortopulmonary fistula formation. However, the current literature offers limited insight into the understanding and management of this condition. Here, we describe the case of a male patient in his late 50s with a history of endovascular repair of chronic Type B dissection of the thoracic aorta, who subsequently developed a complicated aortopulmonary fistula manifesting with recurrent hemoptysis and chest pain. Following extensive evaluations and treatments, the patient underwent open thoracotomy for surgical repair, resulting in a favorable postoperative outcome. Aortopulmonary fistula represents a rare yet significant complication of endovascular procedures. Timely diagnosis and surgical intervention are paramount for enhancing clinical outcomes, although additional research is warranted to enhance our understanding of its pathophysiology and to develop more effective therapeutic approaches. Multidisciplinary collaboration and ongoing follow-up are imperative for managing this complex clinical condition.