Free Esophageal Perforation Following Hybrid Visceral Debranching and Distal Endograft Extension to Repair a Ruptured Thoracoabdominal Aortic Aneurysm

Free esophageal perforation following a hybrid visceral debranching and distal endograft extension to repair a ruptured thoracoabdominal aortic aneurysm (TAAA) is a rare complication. The authors report a 56-year-old male who underwent elective thoracic endovascular aortic repair of a thoracic aneur...

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Bibliographic Details
Published in:Vascular and endovascular surgery 2016-10, Vol.50 (7), p.502-506
Main Authors: Abou-Al-Shaar, Hussam, Zaza, Khaled Juan, Sharif, Muhammad Anees, Koussayer, Samer
Format: Article
Language:English
Subjects:
Aortic Aneurysm, Thoracic - diagnostic imaging
Aortic Aneurysm, Thoracic - surgery
Aortic Rupture - diagnostic imaging
Aortic Rupture - surgery
Aortography - methods
Blood Vessel Prosthesis
Blood Vessel Prosthesis Implantation - adverse effects
Blood Vessel Prosthesis Implantation - instrumentation
Computed Tomography Angiography
Emergencies
Endovascular Procedures - adverse effects
Endovascular Procedures - instrumentation
Esophageal Perforation - diagnostic imaging
Esophageal Perforation - etiology
Esophageal Perforation - surgery
Humans
Male
Middle Aged
Prosthesis Design
Reoperation
Stents
Time Factors
Treatment Outcome
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Summary:Free esophageal perforation following a hybrid visceral debranching and distal endograft extension to repair a ruptured thoracoabdominal aortic aneurysm (TAAA) is a rare complication. The authors report a 56-year-old male who underwent elective thoracic endovascular aortic repair of a thoracic aneurysm. Four and a half years later, he presented with a new aneurysm extending from the distal end of the thoracic stent graft to the aortic bifurcation involving all the visceral arterial branches. The TAAA ruptured while he was awaiting an elective repair, and as a result, he underwent an emergency hybrid procedure. This involved debranching the visceral arterial branches including autotransplantation of the left kidney and distal endograft extension. Postoperatively, he developed free esophageal perforation secondary to ischemic necrosis requiring esophageal resection and gastric pull-up. The patient was well 6 months after the gastrointestinal restorative procedure. Thus, esophageal perforation following an emergency hybrid repair of ruptured TAAA is a rare complication, and a successful outcome depends on early recognition and surgical exclusion of the ruptured viscus.
ISSN:1538-5744
1938-9116
DOI:10.1177/1538574416664441