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J Thorac Cardiovasc Surg 2005;129:458-459
© 2005 The American Association for Thoracic Surgery

Brief Communications

Aortoesophageal fistula as a late complication of aortic transection

Heyman Luckraz, FRCS*, Saif Kitchlu, FRCS, Aprim Youhana, FRCS

Cardiothoracic Unit, Morriston Hospital, Swansea, United Kingdom

Received for publication May 12, 2004; accepted for publication May 21, 2004.

* Address for reprints: Heyman Luckraz, FRCS, Cardiothoracic Unit, Morriston Hospital, Swansea SA6 6NL, UK (E-mail: HeymanLuckraz@aol.com).

The first 20% of the full text of this article appears below.

Acute aortic transection carries a high mortality, with death occurring in up to 90% of patients and with fewer than 5% surviving for longer than 14 days. Chronic false aneurysm develops in patients who survive an acute aortic rupture without operation.1 Chronic traumatic aortic aneurysm involves either partial or complete disruption of at least the intima and media and develops 3 months or more after a major deceleration injury.

The natural history of chronic pseudoaneurysms is unclear. Most likely, thrombus develops within the disrupted portion of the aortic wall and then forms a fibrous wall that calcifies with time. Later on, it may expand or even rupture.

It has been reported that 20-year survival of patients with chronic traumatic aortic aneurysm is around 60%, with half having symptoms by 10 years and a third dying of late rupture.2 Symptoms develop as a result of aneurysm expansion and its impact on surrounding structures. Back pain is the most common presentation. Other presenting . . . [Full Text of this Article]






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