Successful Management of Esophagoparaprosthetic Fistula After Aortic Surgery Shunsuke Kawamoto, MD, PhD, Yoshikatsu Saiki, MD, PhD, Katsuhiko Oda, MD,

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Successful Management of Esophagoparaprosthetic Fistula After Aortic Surgery Shunsuke Kawamoto, MD, PhD, Yoshikatsu Saiki, MD, PhD, Katsuhiko Oda, MD, PhD, Yoshio Nitta, MD, PhD, Jun-etsu Akasaka, MD, PhD, Shukichi Miyazaki, MD, PhD, Koichi Tabayashi, MD, PhD The Annals of Thoracic Surgery Volume 85, Issue 4, Pages 1449-1451 (April 2008) DOI: 10.1016/j.athoracsur.2007.10.068 Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Lateral view of the chest x-ray demonstrating the endovascular stent covering the entire descending thoracic aorta. The yellow arrows indicate coils that had been used to embolize the bronchial arteries. (B) Computed tomographic scan shows the communication (yellow arrow) between the esophagus and the paraprosthetic graft space. (C) Endoscopic examination demonstrating the esophageal ulcer with suture material visible at the bottom (green arrow). (D) Intraoperative photograph showing the disrupted proximal anastomosis. The endovascular stent graft (green arrow) was directly visualized through the disrupted anastomosis. The Annals of Thoracic Surgery 2008 85, 1449-1451DOI: (10.1016/j.athoracsur.2007.10.068) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Serial sections of a computed tomographic scan at 9 months after surgical repair demonstrating the omental flap covering the entire composite graft (green arrows). The Annals of Thoracic Surgery 2008 85, 1449-1451DOI: (10.1016/j.athoracsur.2007.10.068) Copyright © 2008 The Society of Thoracic Surgeons Terms and Conditions