Cor Vasa 2020, 62(3):319-324 | DOI: 10.33678/cor.2019.073

(Aortoesophageal fistula as a fatal complication of dilated descending aorta in chronic aortic dissection)

Kamila Blechová^a, Jiří Knot^a, Arpád Szabó^b

^a III. interní-kardiologická klinika, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

^b Ústav patologie, 3. lékařská fakulta Univerzity Karlovy a Fakultní nemocnice Královské Vinohrady, Praha

Aortoesophageal fistula (AEP) is defined as a pathological communication between the aorta and the esophagus. This condition is associated with high mortality and morbidity. AEP is characterized by a set of symptoms called the Chiari Triad. Typical symptoms are chest pain or dysphagia, gastrointestinal bleeding, and massive hematemesis occurring after a symptom-free period. There are two types of AEP - primary and secondary. The most common causes of the primary AEP are thoracic aortic aneurysms, foreign bodies swallowing, esophagus tumors, traumatic aortic injuries, and TB. The secondary AEP arises as a complication of thoracic endovascular aortic repair (TEVAR), surgery on the aorta, resp. esophagus. Currently, CT angiography and endoscopy diagnostic methods are most preferred for AEP detection. The main reasons for using these methods are availability and high-resolution ability. The detection of AEP is often diagnosed post-mortem due to fulminant progress. A therapy of AEP is an urgent endovascular treatment in the form of stent-graft implantation, which can prevent immediate exsanguination of the patient. This paper describes a patient with AEP and introduces a basic overview of this rare but severe disease.

Keywords: Aortic aneurysm, Aortic dissection, Aortoesophageal fistula, Hematemesis, TEVAR

Received: July 16, 2019; Revised: July 16, 2019; Accepted: November 8, 2019; Published: July 29, 2020  Show citation