The Cause of Massive Hemoptysis After Thoracic Endovascular Aortic Repair May Not Always Be an Aortobronchial Fistula: Report of a Case

Abstract

Hemoptysis after thoracic endovascular/open aortic repair is relatively rare but a well-known complication, and normally diagnosed with aortobronchial fistula (ABF). Here, we present a patient who suffered from recurrent massive hemoptyses even after multiple thoracic endovascular aortic repairs (TEVARs), where hemoptysis was ultimately controlled by pneumonectomy. In this case, the bleeding source was not the aorta but the lung parenchyma itself, indicating the importance of raising awareness that the cause of massive hemoptysis after TEVAR may not always be an ABF.

Manejo endovascular de hemoptisis secundaria a pseudoaneurisma de la aorta torácica, mediante un abordaje proximal.

“…La fístula aorto-bronquial (FAB) es una complicación relativamente rara, sin embargo, bien conocida después de la reparación endovascular (TEVAR) o abierta de la aorta torácica, siendo el síntoma principal la hemoptisis 5 . Sus etiologías incluyen aterosclerosis, infecciones, trauma y post quirúrgicas 6 .…”

Treatment of Massive Hemoptysis After Thoracic Aortic Aneurysm Repair

“…2015;Karube et al 2019;Sueyoshi et al 2018). On the other hand, hemoptysis in patients with TAA repair is known to occur other than ABF and pulmonary artery aneurysm rupture associated with a mycotic TAA(Ishikawa et al 2019), and the chronic in ammatory reaction of lung parenchyma secondary to dispersion of atheroma and/or cholesterol embolization of pulmonary vessels caused during a previous impending TAA rupture(Ishikawa et al 2020;Motohashi et al 2020) are reportedly its etiology.…”