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Aortopulmonary Fistula Presenting without an Endoleak after Thoracic Endovascular Aortic Repair

  • Sica, Giacomo (Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital) ;
  • Rea, Gaetano (Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital) ;
  • Bocchini, Giorgio (Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital) ;
  • Lombardi, Romilda (Division of Radiology, Department of Diagnostic Imaging, AO Rummo) ;
  • Muto, Massimo (Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital) ;
  • Valente, Tullio (Division of Radiology, Department of Diagnostic Imaging, Monaldi Hospital)
  • Received : 2016.11.10
  • Accepted : 2017.03.29
  • Published : 2017.08.05

Abstract

Herein, we report the case of a 60-year-old man, a smoker with a history of arterial hypertension and diabetes mellitus. After computed tomography (CT) for an episode of hemoptysis, the patient underwent elective thoracic endovascular aortic repair (TEVAR) because of a degenerative aneurysm of the descending thoracic aorta. The area of perianeurysmal pulmonary atelectasis reported on the CT scan was not considered. Three months later, he developed an aortopulmonary fistula without endoleaks. Although TEVAR is a relatively safe procedure, no detail should be overlooked in the preoperative evaluation in order to avoid life-threatening complications. Further, the effectiveness and modality of prolonged antibiotic prophylaxis and/or preoperative respiratory physiotherapy should be assessed in such cases.

Keywords

References

  1. Shang EK, Nathan DP, Boonn WW, et al. A modern experience with saccular aortic aneurysms. J Vasc Surg 2013;57:84-8. https://doi.org/10.1016/j.jvs.2012.07.002
  2. Czerny M, Reser D, Eggebrecht H, et al. Aorto-bronchial and aorto-pulmonary fistulation after thoracic endovascular aortic repair: an analysis from the European Registry of Endovascular Aortic Repair Complications. Eur J Cardiothorac Surg 2015;48:252-7. https://doi.org/10.1093/ejcts/ezu443
  3. Valente T, Rossi G, Rea G, et al. Multidetector CT findings of complications of surgical and endovascular treatment of aortic aneurysms. Radiol Clin North Am 2014;52:961-89. https://doi.org/10.1016/j.rcl.2014.05.002
  4. Coselli JS, Spiliotopoulos K, Preventza O, de la Cruz KI, Amarasekara H, Green SY. Open aortic surgery after thoracic endovascular aortic repair. Gen Thorac Cardiovasc Surg 2016;64:441-9. https://doi.org/10.1007/s11748-016-0658-8
  5. Roselli EE, Abdel-Halim M, Johnston DR, et al. Open aortic repair after prior thoracic endovascular aortic repair. Ann Thorac Surg 2014;97:750-6. https://doi.org/10.1016/j.athoracsur.2013.10.033
  6. Kim JT, Yoon YH, Lim HK, Yang KH, Baek WK, Kim KH. Thoracic endovascular stent graft repair for aortic aneurysm. Korean J Thorac Cardiovasc Surg 2011;44:148-53. https://doi.org/10.5090/kjtcs.2011.44.2.148
  7. Irwin RS. Complications of cough: ACCP evidence-based clinical practice guidelines. Chest 2006;129(1 Suppl):54S-58S. https://doi.org/10.1378/chest.129.1_suppl.54S
  8. Erbel R, Aboyans V, Boileau C, et al. 2014 ESC guidelines on the diagnosis and treatment of aortic diseases: document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J 2014;35:2873-926. https://doi.org/10.1093/eurheartj/ehu281
  9. Varela G, Ballesteros E, Jimenez MF, Novoa N, Aranda JL. Cost-effectiveness analysis of prophylactic respiratory physiotherapy in pulmonary lobectomy. Eur J Cardiothorac Surg 2006;29:216-20. https://doi.org/10.1016/j.ejcts.2005.11.002
  10. Katsura M, Kuriyama A, Takeshima T, Fukuhara S, Furukawa TA. Preoperative inspiratory muscle training for postoperative pulmonary complications in adults undergoing cardiac and major abdominal surgery. Cochrane Database Syst Rev 2015;(10):CD010356.
  11. Mans CM, Reeve JC, Elkins MR. Postoperative outcomes following preoperative inspiratory muscle training in patients undergoing cardiothoracic or upper abdominal surgery: a systematic review and meta analysis. Clin Rehabil 2015;29:426-38. https://doi.org/10.1177/0269215514545350

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