CASE REPORT article
Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1633808
This article is part of the Research TopicExploring New Frontiers in Heart Surgery: Case Studies 2025View all 19 articles
Case Report: Area of focus in a case of giant aortic arch pseudoaneurysm following fish bone penetration
Provisionally accepted
- 1Cardiac macrovascular Surgery First Affiliated Hospital of Gannan Medical University, Ganzhou, China
- 2First Clinical Medical College, Gannan Medical University, Ganzhou, China
- 3Department of Cardiovascular Surgery, Beijing Anzhen Hospital Affiliated to Capital Medical University, Beijing, China
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Background: Esophageal foreign body impaction represents a common clinical emergency. In severe cases, it can lead to esophageal perforation and aortic injury, potentially causing life-threatening aorto-esophageal fistulas. While immediate intervention is critical, concurrent infection and retained foreign material substantially complicate management. Case Presentation: We report a rare case of a giant aortic arch pseudoaneurysm secondary to a migratory fish bone. Contrast-enhanced computed tomography (CT) confirmed the diagnosis, prompting urgent surgery. Median sternotomy under cardiopulmonary bypass enabled simultaneous foreign body extraction and aortic perforation repair using autologous pericardium. We reconstructed the aortic arch using a branched stent-graft system via the frozen elephant trunk (FET) technique. Postoperatively, systematic mediastinal irrigation, proactive gastrointestinal decompression, and protocolized enteral nutritional support facilitated complete recovery without requiring secondary esophageal reconstruction. Conclusion: Aortic injuries resulting from esophageal foreign bodies frequently necessitate a multidisciplinary approach.This case demonstrates the feasibility of a single-stage surgical strategy combining aortic repair via the frozen elephant trunk technique with conservative, non-operative management of the concomitant esophageal injury, facilitated by rigorous postoperative care. Treatment strategies must be individualized based on a comprehensive assessment of the aortic involvement pattern, anatomical location, and coexisting pathological conditions.
Keywords: Aortic Arch Pseudoaneurysm, Esophageal Fistula, foreign body, Emergency surgery, one-stage recovery
Received: 23 May 2025; Accepted: 06 Oct 2025.
Copyright: © 2025 Xiong, Cao, Yu, Li, Zeng and Pan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xudong Pan, spjrd@aliyun.com
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