[Open Repair of the Thoracic Aorta Using the Clamshell Approach Because of Aortooesopheagel Fistula - a Multidisciplinary Approach].

INTRODUCTION

Aortoesophageal fistula (AEF) following open or endovascular operations of the thoracoabdominal aorta is a rare, yet life-threatening condition. In this case, the whole thoracic aorta has to be replaced using a "clamshell approach" because of an AEF following open repair of the ascending aorta after type A dissection and a thoracic endovascular aortic repair (TEVAR).

CASE REPORT: In 2015 a 43-year old woman suffered a type A dissection and underwent open supracoronary ascending aortic replacement including the proximal aortic arch. In 2016, she developed severe haemoptysis. An AEF could be detected and TEVAR was performed as emergency treatment. The further steps of the repair included oesophagectomy and repair of the whole thoracic aorta using a transverse thoracotomy - a clamshell approach.

CONCLUSION

The curative treatment of AEF, which is based on radical, open repair of the oesophagus and the involved aortic segments, is challenging. A clamshell approach is a feasible option when replacement of the whole thoracic aorta is required.