Rescue Extracorporeal Bypass to Prevent Atrioesophageal Fistula-related Air Embolism

Abstract

Atrioesophageal fistula (AEF) is a rare but disastrous complication encountered after radiofrequency catheter ablation for atrial fibrillation or flutter. Furthermore cerebral air embolism due to AEF is considered a strong predictor of mortality. In our case a patient presented with AEF and cerebral air embolism. As a rescue effort ventricular fibrillation was induced and sustained under venoarterial extracorporeal membrane oxygenation support until emergency AEF repair was feasible. Herein we report the successful use of the above measures to prevent further air embolism in a patient with radiofrequency catheter ablation-related AEF. (C) 2020 by The Society of Thoracic Surgeons