Esophageal necrosis after endovascular repair for ruptured aortic dissection

Asian Cardiovasc Thorac Ann. 2017 Nov;25(9):638-641. doi: 10.1177/0218492316654035. Epub 2016 Jun 9.

Abstract

A 78-year-old man presented with back pain and shock and was transferred to our hospital. Computed tomography showed a ruptured aortic dissection in which the false lumen was thrombosed with an ulcer-like projection, and the mid-esophagus was shifted to the right due to a mediastinal hematoma. He underwent emergency thoracic endovascular aortic repair of the descending thoracic aorta. One week later, esophageal necrosis occurred, and he died of mediastinitis and sepsis on postoperative day 16. Although esophageal necrosis is a rare and fatal complication after thoracic endovascular aortic repair, a management strategy has not yet been established.

Keywords: Aneurysm; Aortic aneurysm; Blood vessel prosthesis implantation; Endovascular procedures; Esophageal diseases; Postoperative complications; dissecting; thoracic.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortic Dissection / diagnostic imaging
  • Aortic Dissection / surgery*
  • Aortic Rupture / diagnostic imaging
  • Aortic Rupture / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Computed Tomography Angiography
  • Endovascular Procedures / adverse effects*
  • Esophageal Stenosis / diagnostic imaging
  • Esophageal Stenosis / etiology*
  • Esophageal Stenosis / pathology
  • Esophagus / blood supply*
  • Esophagus / diagnostic imaging
  • Esophagus / pathology*
  • Fatal Outcome
  • Hematoma / diagnostic imaging
  • Hematoma / etiology*
  • Humans
  • Ischemia / diagnostic imaging
  • Ischemia / etiology*
  • Ischemia / pathology
  • Male
  • Necrosis
  • Treatment Outcome