Late Development of Aortic Pseudoaneurysm after Coarctation Repair with Fistulization to the Bronchial tree. A Case Report

(#1998-5461 ... August 24, 1998)

Carlos Miramontes, MD, César Villaseñor, MD, Verónica Cadena, MD, Juan C. Olivares, MD and Moisés Calderón, MD

Instituto Mexicano del Seguro Social, La Herradura, Edo Mex, México
Department of Cardiac Surgery and Circulatory Support, Centro, Médico La Raza, IMSS México, D.F., México

ABSTRACT

Background: Fistulous communication between the aorta and the tracheobronchial tree is an uncommon and serious cause of hemoptysis secondary to complications of a previous operation performed on the aorta. In cases in which an appropriate surgical intervention is carried out, the survival rate approaches 76%. This surgery is considered one of the most risky operations on the aorta, challenging the surgeon's ability to resolve the problem.

Methods: We present the case report of a 43-year-old female with massive hemoptysis. Her medical history disclosed repair of coarctation of the aorta (15 years before). She underwent emergency left thoracotomy; surgical exploration revealed a false aneurysm from the previous aortic patch repair which communicated to a subsegmental bronchus of the left upper lobe.

Results: The thoracic aorta was isolated and clamped, and the previous patch was removed. The bronchial side of the fistula was managed with left superior lobectomy and the aorta was repaired with the placement of a coated woven dacron graft onto healthy aortic tissue.

Conclusions: The patient had an uneventful recovery and remains asymptomatic six months after discharge.

AUTHOR/ARTICLE INFORMATION

Reprint requests to: Moisés Calderon, MD, Paseo de la Soledad 69, La Herradura, Edo Mex, 53920, México

Keywords: Aortic pseudoaneurism, aortobronchial fistula, coarctation of the aorta

Submitted on: August 20, 1998