Single-stage multidisciplinary surgical repair of a secondary aortoesophageal fistula : A technical case report with 3-year uneventful follow-up
Zeyara, Adam LU
; Al Saedi, Firas
; Fransson, Torbjörn
LU
; Nozohoor, Shahab
LU
; Ahl, Jonas
LU
; Wierup, Per
LU
and Johansson, Jan
LU
(2026)
In JTCVS Techniques
38.
- Abstract
OBJECTIVE: Secondary aortoesophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) is a rare but life-threatening complication. Definitive treatment guidelines are lacking, and surgical management has traditionally relied on staged procedures. Reports of successful single-stage repair with long-term follow-up remain scarce. This case report aims to describe the workup, surgical strategy, and long-term outcomes of a single-stage multidisciplinary repair of secondary AEF after TEVAR.
METHODS: We report the case of a 75-year-old man who presented with recurrent infectious episodes 9 years after TEVAR. A secondary AEF was diagnosed in May 2022. After the failure of conservative treatment (ie, antibiotic therapy) over... (More)
OBJECTIVE: Secondary aortoesophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) is a rare but life-threatening complication. Definitive treatment guidelines are lacking, and surgical management has traditionally relied on staged procedures. Reports of successful single-stage repair with long-term follow-up remain scarce. This case report aims to describe the workup, surgical strategy, and long-term outcomes of a single-stage multidisciplinary repair of secondary AEF after TEVAR.
METHODS: We report the case of a 75-year-old man who presented with recurrent infectious episodes 9 years after TEVAR. A secondary AEF was diagnosed in May 2022. After the failure of conservative treatment (ie, antibiotic therapy) over approximately 1 year, a multidisciplinary team recommended definitive surgery. In April 2023, a single-stage repair was performed, comprising complete resection of the infected stent graft, in situ replacement with an antibiotic-soaked prosthesis, primary esophageal repair, and interposition of a pedicled latissimus dorsi muscle flap.
RESULTS: The patient was discharged on postoperative day 30. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.
CONCLUSIONS: In this case report, a single-stage multidisciplinary surgical repair of secondary AEF after TEVAR yielded durable infection control and favorable long-term outcomes. Careful patient selection within a multidisciplinary team, meticulous surgical planning, and close postoperative infectious disease follow-up are essential. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.
(Less)
- author
- Zeyara, Adam
LU
; Al Saedi, Firas
; Fransson, Torbjörn
LU
; Nozohoor, Shahab
LU
; Ahl, Jonas
LU
; Wierup, Per
LU
and Johansson, Jan
LU
- publishing date
- 2026-08
- type
- Contribution to journal
- publication status
- published
- subject
- in
- JTCVS Techniques
- volume
- 38
- article number
- 102417
- publisher
- Elsevier
- external identifiers
-
- pmid:42577133
- scopus:105040940057
- ISSN
- 2666-2507
- DOI
- 10.1016/j.xjtc.2026.102417
- language
- English
- LU publication?
- no
- additional info
- © 2026 The Author(s).
- id
- 34d85878-c048-4b0f-a4e4-efa3b55b2a4d
- date added to LUP
- 2026-08-24 08:45:27
- date last changed
- 2026-08-25 04:01:14
@article{34d85878-c048-4b0f-a4e4-efa3b55b2a4d,
abstract = {{<p>OBJECTIVE: Secondary aortoesophageal fistula (AEF) after thoracic endovascular aortic repair (TEVAR) is a rare but life-threatening complication. Definitive treatment guidelines are lacking, and surgical management has traditionally relied on staged procedures. Reports of successful single-stage repair with long-term follow-up remain scarce. This case report aims to describe the workup, surgical strategy, and long-term outcomes of a single-stage multidisciplinary repair of secondary AEF after TEVAR.</p><p>METHODS: We report the case of a 75-year-old man who presented with recurrent infectious episodes 9 years after TEVAR. A secondary AEF was diagnosed in May 2022. After the failure of conservative treatment (ie, antibiotic therapy) over approximately 1 year, a multidisciplinary team recommended definitive surgery. In April 2023, a single-stage repair was performed, comprising complete resection of the infected stent graft, in situ replacement with an antibiotic-soaked prosthesis, primary esophageal repair, and interposition of a pedicled latissimus dorsi muscle flap.</p><p>RESULTS: The patient was discharged on postoperative day 30. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.</p><p>CONCLUSIONS: In this case report, a single-stage multidisciplinary surgical repair of secondary AEF after TEVAR yielded durable infection control and favorable long-term outcomes. Careful patient selection within a multidisciplinary team, meticulous surgical planning, and close postoperative infectious disease follow-up are essential. Three-year follow-up demonstrated sustained remission with normalized inflammatory markers and no evidence of graft reinfection.</p>}},
author = {{Zeyara, Adam and Al Saedi, Firas and Fransson, Torbjörn and Nozohoor, Shahab and Ahl, Jonas and Wierup, Per and Johansson, Jan}},
issn = {{2666-2507}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{JTCVS Techniques}},
title = {{Single-stage multidisciplinary surgical repair of a secondary aortoesophageal fistula : A technical case report with 3-year uneventful follow-up}},
url = {{http://dx.doi.org/10.1016/j.xjtc.2026.102417}},
doi = {{10.1016/j.xjtc.2026.102417}},
volume = {{38}},
year = {{2026}},
}