An Unusual Case of Dysphagia After Endovascular Exclusion of Thoracoabdominal Aortic Aneurysm

Abstract

Acute dysphagic syndrome after thoracic aorta endografting has been anecdotically reported, and its etiology remains undefined. In this report, we illustrate the clinical features of this rare condition, discuss etiological hypotheses, and suggest a noninvasive therapeutic approach.

Cardiovascular dysphagia — anatomical and clinical implications

“…A barium oesophagogram demonstrated a typical 'bird's beak' appearance, with dilation of the upper and middle oesophagus. Endoscopic injections of 100 IU of botulinum toxin a at the lower oesophageal sphincter completely relieved the symptoms [54].…”

“…Postoperative dysphagia was reported following vascular ring division [9], type I thoracoabdominal aneurysm repair [33], arterial switch with the Lecompte maneuver [71], coil embolisation of an aortopulmonary collateral artery [8], and thoracic endovascular aortic repair [22]. Acute dysphagic syndrome after thoracic aorta endografting has been anecdotically reported, and its aetiology remains undefined [54]. A 79-year--old woman manifested acute dysphagia after endovascular exclusion of thoracoabdominal aortic aneurysm.…”

Hybrid procedures for complex thoracoabdominal aortic aneurysms in high-risk patients

“…Complications that were lately pre-sented were: visceral graft occlusion rate (6.8%), one case of endoleak (3.2%), one case of migration (3.2%), one case of acute pancreatitis (3.2%), and one case of dysphagia and regurgitation (3.2%), suggesting the development of a secondary achalasia. 18 Visceral aortic patch dilatation or aneurysm after TAAA conventional repair is not uncommon, it may lead to aortic rupture, and is particularly frequent in patients with connective tissue disorders, dissecting aneurysm, or prior thoracic or AAA repair. 19 All of the patients included in the study had undergone prior aortic surgery, and the incidence of dilatation of visceral aortic patch in the conventionally treated group was high (3 cases, 10.3%).…”