Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure
A 66-year-old female with a history of radiofrequency ablation for atrial fibrillation presented with hematemesis and fever. A CT chest revealed an atrio-esophageal fistula (AEF) and a CT head showed bilateral septic emboli. Blood cultures were positive for Streptococcus sanguinis. She underwent pri...
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Wiley
2023-01-01
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| Series: | Case Reports in Critical Care |
| Online Access: | http://dx.doi.org/10.1155/2023/3930221 |
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| author | I. A. Sanoja |
| author_facet | I. A. Sanoja |
| author_sort | I. A. Sanoja |
| collection | DOAJ |
| description | A 66-year-old female with a history of radiofrequency ablation for atrial fibrillation presented with hematemesis and fever. A CT chest revealed an atrio-esophageal fistula (AEF) and a CT head showed bilateral septic emboli. Blood cultures were positive for Streptococcus sanguinis. She underwent primary repair of the atrial defect on cardiopulmonary bypass where a large atrial vegetation was retrieved, followed by a right thoracotomy with the closure of the esophageal defect the next day. She was discharged to a rehabilitation facility after 18 days of hospital stay with a 6 weeks antibiotics plan. The incidence of AEF following ablation procedures has been estimated at 0.01 to 0.04%, and the pathogenesis is linked to direct tissue and vagus nerve injury. The most common clinical findings are fever and neurologic deficits. CT chest is the best diagnostic modality. CT head might demonstrate embolic phenomena and TTE can show vegetation. Early surgical intervention, even in an unstable patient, is paramount for survival. |
| format | Article |
| id | doaj-art-d99fa12cbf2f4e30b133b67e768de7f3 |
| institution | OA Journals |
| issn | 2090-6439 |
| language | English |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Critical Care |
| spelling | doaj-art-d99fa12cbf2f4e30b133b67e768de7f32025-08-20T02:21:12ZengWileyCase Reports in Critical Care2090-64392023-01-01202310.1155/2023/3930221Atrio-Esophageal Fistula: A Rare Entity Complicating a Common ProcedureI. A. Sanoja0Oregon Health and Science UniversityA 66-year-old female with a history of radiofrequency ablation for atrial fibrillation presented with hematemesis and fever. A CT chest revealed an atrio-esophageal fistula (AEF) and a CT head showed bilateral septic emboli. Blood cultures were positive for Streptococcus sanguinis. She underwent primary repair of the atrial defect on cardiopulmonary bypass where a large atrial vegetation was retrieved, followed by a right thoracotomy with the closure of the esophageal defect the next day. She was discharged to a rehabilitation facility after 18 days of hospital stay with a 6 weeks antibiotics plan. The incidence of AEF following ablation procedures has been estimated at 0.01 to 0.04%, and the pathogenesis is linked to direct tissue and vagus nerve injury. The most common clinical findings are fever and neurologic deficits. CT chest is the best diagnostic modality. CT head might demonstrate embolic phenomena and TTE can show vegetation. Early surgical intervention, even in an unstable patient, is paramount for survival.http://dx.doi.org/10.1155/2023/3930221 |
| spellingShingle | I. A. Sanoja Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure Case Reports in Critical Care |
| title | Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure |
| title_full | Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure |
| title_fullStr | Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure |
| title_full_unstemmed | Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure |
| title_short | Atrio-Esophageal Fistula: A Rare Entity Complicating a Common Procedure |
| title_sort | atrio esophageal fistula a rare entity complicating a common procedure |
| url | http://dx.doi.org/10.1155/2023/3930221 |
| work_keys_str_mv | AT iasanoja atrioesophagealfistulaarareentitycomplicatingacommonprocedure |