Successful Diagnosis and Management of Fistulas Between the Aorta and the Tracheobronchial Tree

Aortobronchial fistula occurring after coarctation repair: findings on aortography, helical CT, and CT angiography.

“…The clot is eventually degraded, causing repeated hemorrhage followed by new clot formation. With each episode, the fistula be comes larger and more prone to exsan guination [2,4]. The average time between the first episode of hemoptysis and fatal hemorrhage is nearly 5 months [1].…”

“…Most patients have an aortic aneurysmor have had prioraorticsurgery [3], andtypicallyprodromal hemoptysisprecedesexsanguination [4]. We present a patient who developed intermittent hemoptysis14 yearsafterrevisionof an aortic coarctationrepair.An aortobronchialfistula was suspectedpreoperativelyafter aortographyand helical CT, and the patient underwentsuccess ful repair ofthe fistula.…”

Aortobronchial fistula after correction of congenital cardiovascular abnormalities

“…Depending on the size of the new defect, a prosthetic graft may be required, although sometimes the fistula can be closed by direct suture. To prevent direct contact between the vascular reconstruction and the pulmonary tissue, the new graft and suture lines should be covered by the remains of the aneurysm wall, if present, or by surrounding viable tissue, such as intercostal muscle, pleural or pericardial flaps, thymic fat or even by an omental pedicle [3].…”

Aortobronchial Fistula Complicated with an Aortic Aneurysm in Hemodialysis Patient

“…Hemoptysis is the most frequent symptom and occurs in over 95% of the cases [2]. However, hemoptysis is some times only small in amount and intermittent, which can lead to the misdiagnosis as bronchitis [5,6]. The aneur ysm invades the lung by pressure or chronic inflamma tion to represent hemoptysis.…”

“…The patient does not com plain of hemoptysis until the formation of thrombus in fistula. The duration to the presentation with massive hemoptysis in the past cases varied, from 2 days to 1 year [6,7]. Other symptoms include chest pain, cough and dyspnea.…”