A Case of Aortopulmonary Fistula Caused by a Huge Thoracic Aortic Aneurysm

Kim, Sang-Eok; Kim, Hyong-Jun; Lee, Soo-Hoon; Lee, Kwang-Hee; Kim, Ki‐Young; Yoon, Jin-Woo; Bae, Soo-Kyung; Choi, Sung-Uk; Rho, Byung-Hak

doi:10.4070/kcj.2009.39.5.209

Cited by 8 publications

(8 citation statements)

References 9 publications

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“…An aortic aneurysm is one such complication 5. In rare instances, aortic aneurysm may lead to further complications of fistula formation between the aorta and the pulmonary artery 1 6. In 1924, Boyd reported that the occurrence of aortopulmonary fistula was nearly 4% among the 4000 autopsy cases with thoracic aortic aneurysm investigated in the study 7.…”

Section: Discussionmentioning

confidence: 99%

“…Although the majority of patients with aortopulmonary fistula remain asymptomatic, when they do occur, symptoms may include chest pain, haemoptysis and dyspnoea 1 6. Further, an aortic aneurysm of more than 6 cm diameter is common in patients with aortopulmonary fistulae and is frequently associated with the development of acute left-to-right shunt, new murmur, systemic arterial hypertension, signs of cardiac insufficiency and severe pulmonary hypertension 1 2.…”

Section: Discussionmentioning

confidence: 99%

“…Further, an aortic aneurysm of more than 6 cm diameter is common in patients with aortopulmonary fistulae and is frequently associated with the development of acute left-to-right shunt, new murmur, systemic arterial hypertension, signs of cardiac insufficiency and severe pulmonary hypertension 1 2. In the presenting case, we found an aortic aneurysm communicating with the pulmonary artery leading to an acute left-to-right shunt, with volume overload of the left ventricle causing acute congestive heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…Aortopulmonary fistulae, reported since 1812, are an unusual complication of aortic aneurysms rupturing into the pulmonary artery 1 2. Very few patients survive rupture of an aortic aneurysm as it may lead to cardiac tamponade or haemorrhagic shock and ultimately death 2.…”

Section: Introductionmentioning

confidence: 99%

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A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

2014

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An acquired aortopulmonary fistula is a rare and usually fatal phenomenon. Rarer still are reports of successful surgical repair of aortopulmonary fistulae. We present the case of a 48-year-old hypertensive man who presented with congestive cardiac failure. Examination revealed a bicuspid aortic valve and a large aneurysm of the arch of the aorta, which was communicating with the main pulmonary artery. The diagnosis of acquired aortopulmonary fistula was made using transthoracic echocardiography findings and confirmed by CT. The patient was successfully managed by surgery, with an uneventful postoperative recovery, with control of congestive cardiac failure. At 1-year follow-up, the patient had Class I symptoms.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

2014

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“…Since the patient had no pre-existing pulmonary disease, surgical history and hemoptysis, an aortopulmonary fistula might have formed due to erosion from the continuous pulsatile friction between the pulmonary artery and the aortic aneurysm wall, or an aortobronchial fistula between the aortic and bronchial lumina was created because of compression of the tracheobronchial tree by the enlargement of the thoracic aneurysm. This may have induced pressure necrosis, which can lead to erosion of both the aortic and bronchial walls 15)16). Endovascular stent graft repair of an aortopulmonary fistula appears to be safe and well tolerated 17)…”

Section: Discussionmentioning

confidence: 99%

Successful Treatment of a Ruptured Aortic Arch Aneurysm Using a Hybrid Procedure

Choi

Lee

et al. 2011

Korean Circ J

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Aortic rupture has a high mortality rate and can be considered a medical emergency. The standard treatment for aortic rupture is surgical repair. An aortic stent graft for a ruptured descending aorta is considered an effective alternative treatment. However, an aortic stent graft is difficult when the aortic aneurysm is in the aortic arch due to supra-aortic vessels. We report on a patient with a ruptured aortic arch aneurysm treated with a hybrid procedure, which involved a carotid to carotid bypass operation and an aortic stent graft. A 71-year-old male patient visited our cardiovascular center suffering from hemoptysis. The chest CT and aortography showed a 9 cm sized aortic arch aneurysm 0.5 cm distal to the left subclavian artery and a hemothorax in the left lung. The patient refused to undergo a full open operation. We performed a carotid to carotid bypass in advance, and two pieces of aortic stent grafts were placed across the left carotid artery and left subclavian artery. The follow up CT showed the aortic stent grafts, no endoleaks and no thrombus in the aortic arch aneurysm. The patient was discharged from the hospital without complication.

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Right heart failure caused by direct pressure of distal arch aneurysm

Sugiyama

Tohma

Misato

et al. 2018

Gen Thorac Cardiovasc Surg

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We report a rare case of right heart failure caused by distal aortic aneurysm. Although aortopulmonary fistula is a common complication of giant aortic arch aneurysm, right heart failure caused by mechanical pressure by aneurysm is very rare. A 79-year-old female patient presented dyspnea. Contrast computed tomography (CT) of the thorax delineated a 78 mm aortic arch aneurysm pressing the main to left pulmonary artery and a 40 mm pericardial effusion at maximum depth at posterior side. Echocardiography showed the acceleration flow from main to left pulmonary artery and moderate pulmonary hypertension. Left ventricular function, however, was preserved. We diagnosed right heart failure caused by giant aortic arch aneurysm and performed emergency aortic arch aneurysm replacement. After the operation, pulmonary artery pressure decreased and right heart failure improved.

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A Case of Aortopulmonary Fistula Caused by a Huge Thoracic Aortic Aneurysm

Cited by 8 publications

References 9 publications

A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

Successful Treatment of a Ruptured Aortic Arch Aneurysm Using a Hybrid Procedure

Right heart failure caused by direct pressure of distal arch aneurysm

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