title: Aortobronchial Fistula after Thoracic Endovascular Aortic Repair (TEVAR) for Descending Thoracic Aortic Aneurysm.
abstract: Continued enlargement of the aneurysm sac after thoracic endovascular aortic repair (TEVAR) is a known risk after endovascular treatment of thoracic aortic aneurysms. For this reason, periodic outpatient follow-up is required to identify situations that require repair. Here, we describe an aortobronchial fistula (ABF) in a patient lost to follow-up, that presented 3 years after an elective TEVAR done for a primary, descending thoracic aortic aneurysm. Our patient arrived in extremis and suffered massive hemoptysis leading to her demise. Computed tomography (CT) angiogram near the time of her death demonstrated a bleeding ABF immediately distal to her previous TEVAR repair. Aortic aneurysmal disease remains life threatening even after repair. Improved endovascular techniques and devices have resulted in decreased need for reintervention. However, this case demonstrates the risk of thoracic aortic disease progression and highlights the importance of establishing consistent, long-term follow-up after TEVAR.
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Emory University, Atlanta, GA.
authors.forename: John Nicholas
authors.initials: JN
authors.lastname: Melvan
authors.affiliation: Division of Cardiothoracic Surgery, Department of Surgery, Emory University, Atlanta, GA; Department of Cardiac and Endovascular Surgery, Portneuf Medical Center, Pocatello, ID.
authors.forename: Jacob
authors.initials: J
authors.lastname: DeLaRosa
authors.affiliation: Department of Cardiac and Endovascular Surgery, Portneuf Medical Center, Pocatello, ID. Electronic address: juliov@portmed.org.
authors.forename: Julio C
authors.initials: JC
authors.lastname: Vasquez
mesh_terms: D000369:Aged, 80 and over; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D000072226:Computed Tomography Angiography; D057510:Endovascular Procedures / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology*