# Successful Surgical Therapy of a Chronically Infected Thoracic Fistula After Repeated Cardiovascular High‐Risk Procedures

## TL;DR

A 67-year-old man with a complex heart condition successfully recovered from a chronic infected thoracic fistula through a multidisciplinary surgical approach.

## Contribution

The paper presents a successful surgical strategy for managing a rare complication after transapical TAVI using interdisciplinary care and VAC therapy.

## Key findings

- Complete removal of infected tissue and foreign material was critical for healing.
- Staged debridement and vacuum-assisted closure therapy aided in wound reconstruction.
- Interdisciplinary management improved outcomes in high-risk post-TAVI patients.

## Abstract

Chronic thoracic fistulas after transapical TAVI are rare but serious complications. A 67‐year‐old male with prior aortic dissection and two transapical valve implantations developed a chronically infected fistula due to retained apical closure material. Multidisciplinary surgery with complete removal of infected tissue, staged debridement, vacuum‐assisted closure (VAC) therapy, and targeted antibiotics achieved infection control and successful wound reconstruction using local flaps. The patient recovered uneventfully. Complete foreign material removal and interdisciplinary management are crucial for durable healing in high‐risk posttransapical TAVI patients.