Post-Traumatic Aortic Arch Aneurysm Complicated by Aorto-Pulmonary Fistula

Abstract

We report a rare case of presumed post-traumatic aortic arch aneurysm complicated by an aorto-pulmonary artery fistula. Contrast-enhanced computed tomographic pulmonary angiography completed by dynamic cardiac magnetic resonance imaging allowed adequate preoperative visualization of an 8-mm large fistula between the aneurysm and the left pulmonary artery. The patient underwent successful total aortic arch replacement and closure of the fistula using a patch.

Left Hemiclamshell Approach for Posterior Aortic Arch Aneurysm

“…There was no history of thoracic trauma or infection to contradict this hypothesis. 2 Unlike the case by Buechner et al, 3 EVAR was not practicable for the reasons listed above (i.e., the damage of the left subclavian artery for patient 1 and the short landing zone for patient 2).…”

Post-traumatic aortopulmonary fistula after bentall procedure

“…[ 9 ] It can be spontaneous (degenerative atherosclerosis) or secondary to aortitis, thoracic trauma, dissecting aortic aneurysms, or to a previous aortic aneurysm surgery. [ 9 10 11 12 13 14 15 ] The diagnosis is generally made by CT scan or magnetic resonance imaging (MRI),[ 8 ] but sometimes, it could be detected also by TTE.…”

Diagnosis and Management of Fontan Failure Secondary to Aortopulmonary Artery Fistula

“…Post-release TEE also confirmed the device to be in a the pulmonary artery or its branches was revealed using magnetic resonance imaging (MRI). Trauma is a significant risk factor for the development of mild to severe injuries of the vessel wall that can lead to fistula formation [4,5]. Most vessel wall injuries, even minor ones, would likely be seen on MRI which was not done in this case.…”

“…other hand, acquired APFs are relatively more common and usually associated with pseudo-aneurysm that breaks into the pulmonary artery [2][3][4]. They may or may not be associated with trauma [5]. Treatment for these abnormal communications is well established and is either surgical or percutaneous [2,6].…”