Efficacy of Thoracic Endovascular Aortic Repair for Recurrent Hemoptysis of Bronchial-Pulmonary Artery Fistula Resistance to Several Bronchial Artery Embolization

Hiroaki Yamamoto＊	Hiroyuki Watanabe＊	Masayoshi Otsu＊
Daisuke Kaneyuki＊

（Department of Cardiovascular Surgery, Narita Red Cross Hospital＊, Narita, Japan）

An 84-year-old woman treated for tuberculosis in childhood presented to our emergency department with chronic cough and massive hemoptysis. Contrast-enhanced computed tomography（CT）on admission revealed a bronchial-pulmonary artery fistula（BPAF）for which she underwent bronchial artery embolization（BAE）and developed hemoptysis postoperatively. Contrast-enhanced CT on admission revealed a connection between the right coronary and a bronchial artery, suggesting coronary-to-bronchial artery communication. Hemoptysis persisted despite coiling of a branch of the right coronary artery. Therefore, we were consulted to perform thoracic endovascular aortic repair（TEVAR), which we performed as a semi-emergency. She did not show hemoptysis or paraplegia postoperatively and was discharged on postoperative day 40. TEVAR is effective for a BPAF in patients in whom BAE cannot control hemoptysis.

 

Jpn. J. Cardiovasc. Surg. 49:233-236（2020）

Keywords：hemoptysis;thoracic endovascular aortic repair;bronchial-pulmonary artery fistula;bronchial artery embolization