Surgical management of primary aortoesophageal fistula secondary to thoracic aneurysm

Aortoesophageal fistula, secondary to thoracic aortic aneurysm, is an uncom mon cause of gastrointestinal bleeding that is uniformly fatal without surg ical intervention. These may be primary fistulas, in cases of thoracic aort ic aneurysm without previous repair, or secondary fistulas occurring after surgical repair of thoracic aortic aneurysm. Surgical treatment has been su ccessful in a small number of cases of primary aortoesophageal fistula, sec ondary to thoracic aortic aneurysm, but techniques used have varied. We rep ort a successful repair of primary aortoesophageal fistula, secondary to de scending thoracic aortic aneurysm, and review the evolution of management s ince the three previously reported successful repairs at our institution. ( C) 2000 by The Society of Thoracic Surgeons.