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Aortic graft-enteric fistula

P D Kiernan, P C Pairolero, J P Hubert

    Mayo Clinic Proceedings
    |December 1, 1980
    PubMed
    Summary
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    Surgical repair of aortic graft-enteric fistulas for intestinal bleeding has high operative mortality and low long-term survival. Further research is needed to improve prophylaxis, diagnosis, and intervention strategies for this rare condition.

    Area of Science:

    • Vascular Surgery
    • Gastrointestinal Surgery
    • Infectious Disease

    Background:

    • Aortic graft-enteric fistula is a rare but serious complication following aortic reconstructive surgery.
    • Intestinal bleeding is a critical manifestation, often leading to high morbidity and mortality.
    • Limited data exists on optimal management strategies.

    Purpose of the Study:

    • To review the Mayo Clinic experience with aortic graft-enteric fistula repair.
    • To analyze outcomes from a larger cohort including English literature review.
    • To identify factors influencing prognosis and suggest improvements in patient care.

    Main Methods:

    • Retrospective review of 20 patients undergoing 24 operations at Mayo Clinic over 15 years.
    • Comprehensive literature search of English language publications for additional cases.

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  • Analysis of operative mortality, long-term survival, and potential contributing factors.

    • Main Results:

    • Operative mortality was high: 55% in the Mayo Clinic series and 46% in the literature review.
    • Long-term survival was poor, approximately 15% in both groups.
    • The study highlights the severe nature of this complication.

    Conclusions:

    • Aortic graft-enteric fistula presents a significant surgical challenge with grim outcomes.
    • Improved prophylaxis, earlier diagnosis, and refined interventional techniques are crucial.
    • Multidisciplinary approaches may be necessary to reduce the high mortality and morbidity associated with this condition.