Debranching and Chimney-Assisted Thoracic Endovascular Aortic Repair for Aortopulmonary Fistula From a Ruptured Aortic Arch Aneurysm.
case_report · Level V
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- Record sourced from PubMed, PMID 42061493.
- Also identified by DOI 10.1016/j.athoracsur.2026.04.021.
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Abstract
An aortopulmonary fistula is a rare but catastrophic complication of thoracic aortic aneurysm rupture. An 80-year-old woman presented with shock, respiratory failure, and severe lactic acidosis. Contrast-enhanced computed tomography demonstrated a ruptured saccular aortic arch aneurysm with an aortopulmonary fistula to the left pulmonary artery. Emergent hybrid thoracic endovascular aortic repair with supra-aortic debranching and a chimney graft achieved prompt fistula exclusion. Although a small gutter-related type Ia endoleak persisted, hemodynamics improved. Postoperative computed tomography confirmed aneurysm sac thrombosis and complete fistula closure.