A primary aortocaval fistula (ACF) is a rare complication of abdominal aortic aneurysms caused by erosion of the aortic wall into the vena cava. It is more frequently observed in the setting of ruptured abdominal aortic aneurysms and presents a unique challenge for vascular surgeons. Both open and endovascular techniques exist, with the main differences being perioperative mortality and recurrence rates. We present a case of an ACF diagnosed intraoperatively, which persisted after endovascular aneurysm repair in conjunction with a type II endoleak. We applied a unique staged, triple endovascular approach to close the ACF via caval and aortic exclusion of inflow and outflow vessels.
Keyphrases
- abdominal aortic aneurysm
- abdominal aortic
- aortic dissection
- vena cava
- aortic valve
- inferior vena cava
- left ventricular
- pulmonary artery
- subarachnoid hemorrhage
- cardiac surgery
- minimally invasive
- type diabetes
- cardiovascular events
- heart failure
- risk factors
- coronary artery disease
- quality improvement
- cardiovascular disease
- endovascular treatment