title: Outcome of surgical repair of aorto-eosophageal fistulas with cryopreserved aortic allografts.
abstract: Aorto-oesophageal fistula (AEF) is a rare but life-threatening disease with an underlying infective aetiology that can cause serious complications. This study investigated the clinical outcomes of patients with AEF who received in situ cryopreserved aortic allograft replacement. From August 2000 to February 2011, 11 patients with AEF received aortic allografts; 5 for primary AEF caused by ruptured aortic aneurysm and 6 for secondary AEF that comprised 4 cases following thoracic endovascular aortic repair (TEVAR) and 2 after open graft replacement of the thoracic aorta. As for results, 2 cases of primary AEF received TEVAR and then allograft replacement, one for graft infection and the other for bleeding. Three primary AEF cases received allografts directly. Six secondary AEF cases received staged (5) or simultaneous (1) oesophagectomy and allograft replacement. There were 3 in-hospital deaths (27%), 2 because of bleeding and one because of multisystem organ failure. Four patients completed oesophageal reconstruction. There were 2 late deaths, one due to aspiration pneumonia and one of unknown cause. In conclusion, surgical results for repair of AEF using cryopreserved aortic allograft were satisfactory considering preoperative critical condition, and this type of allograft appears to be an ideal graft of choice.
authors.affiliation: Department of Cardiothoracic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan. ayasaitou-ths@umin.ac.jp
authors.forename: Aya
authors.initials: A
authors.lastname: Saito
authors.forename: Noboru
authors.initials: N
authors.lastname: Motomura
authors.forename: Osamu
authors.initials: O
authors.lastname: Hattori
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.forename: Shogo
authors.initials: S
authors.lastname: Shimada
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
authors.forename: Shunei
authors.initials: S
authors.lastname: Kyo
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000637:transplantation*; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D015925:Cryopreservation; D004937:Esophageal Fistula / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D016629:Esophagectomy; D004945:Esophagoscopy; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014184:Transplantation, Homologous; D016896:Treatment Outcome