Brief communications 13 8 9TEE because of artifacts. In urgent circumstances, even if the need to minimize delay appears to justify the desire to reduce the number of studies, reliable information is mandatory. We therefore believe that only highly accurate techniques such as multiplanar TEE should be employed in diagnosing aortic dissections.

These data suggest that patients with acute type B dissection with a patent false lumen or a diameter > or = 45 mm (or both) during the acute phase are at risk for enlargement of the dissecting aorta. The patients with dissecting aortas > or = 45 mm or a patent false lumen (or both) therefore require close follow-up to detect enlargement of the dissecting aorta, whereas patients with a maximum aortic diameter of < 45 mm with a thrombosed false lumen can stay on conservative therapy.

HighlightsWe report the successful surgical treatment of an ilio-iliac arteriovenous fistula.Although rare, this disease can be life-threatening.Use of multiple imaging modalities facilitates correct preoperative diagnosis.Balloon occlusion technique is used to minimize blood loss during open repair.There was no sign of high-output heart failure because of venous flow failure.

A 79-year-old woman was urgently referred to a district hospital with dull central chest pain after swallowing a fish bone. The bone was removed by esophagoscopy. Eleven days later she presented because of hematemesis. Computed tomography and aortic arch angiography confirmed a diagnosis of esophageal perforation leading to mediastinitis and the presence of an infected pseudoaneurysm. The infected pseudoaneurysm was completely resected, followed by direct aorto-aorta anastomosis and omental coverage in a one-stage operation. She improved and was discharged 2 months later.