title: A bad experience with endovascular treatment of an aortobronchial fistula.
abstract: A 35-year-old woman presented with an aortobronchial fistula after polyester graft replacement of coarctation of the descending thoracic aortic. Treatment of the fistula included antibiotic therapy and stent graft placement. Life-threatening sepsis developed in the postoperative period. Subsequent treatment required excision of the infected graft complex with extra-anatomic reconstruction of the thoracic aorta. The patient had a very stormy postoperative course and required heroic measures, including mechanical circulatory support, to achieve survival. The present case demonstrates failure of endovascular therapy of an aortobronchial fistula. The case should serve as a cautious reminder that the underlying cause for infection remains even after apparent successful endovascular therapy.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: Altarabsheh Salah
authors.initials: AS
authors.lastname: Eldien
authors.forename: Salil
authors.initials: S
authors.lastname: Deo
authors.forename: Francis C
authors.initials: FC
authors.lastname: Nichols
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Greason
mesh_terms: D000328:Adult; D001013:Aorta, Thoracic / Q000601:surgery; D001017:Aortic Coarctation / Q000601:surgery; D001018:Aortic Diseases / Q000209:etiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation; D001983:Bronchial Fistula / Q000209:etiology / Q000601:surgery*; D003131:Combined Modality Therapy; D020878:Device Removal; D057510:Endovascular Procedures; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D006801:Humans; D009102:Multiple Organ Failure / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012772:Shock, Septic / Q000188:drug therapy / Q000209:etiology* / Q000601:surgery; D015607:Stents; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed