Aortopulmonary fistula occurring 19 years after repair of aortic coarctation with Dacron patch aortoplasty

A 39-year-old male patient presented with complaints of cough and hemoptysis. He had a history of aortic coarctation repair with the use of Dacron patch aortoplasty 19 years before.Thoracic aortography showed significant narrowing of the aortic lumen and some extravasation of contrast material in the patch area. Computed tomography angiography of the chest revealed obvious narrowing at the repair site and a double lumen appearance. There was no evidence for a true aneurysm or pseudoaneurysm. Following a left thoracotomy and on partial cardiopulmonary bypass, the Dacron patch and coarctation segment were completely removed. A new Dacron graft of 20 mm was used to restore aortic continuity. A pleural flap was placed on the new Dacron graft to separate it from the lung tissue. The postoperative course was uneventful and the patient was discharged on the fifth postoperative day. Hemoptysis disappeared following the procedure. Magnetic resonance angiography performed three months after the repair showed a patent graft and no coarctation.