Bronchiolo-arterial fistula management in a patient with Loeys-Dietz syndrome using a multidisciplinary approach

TL;DR

A patient with Loeys-Dietz syndrome had chronic hemoptysis successfully treated with surgery after other methods failed.

Contribution

Demonstrates successful multidisciplinary management of a rare bronchiolo-arterial fistula in a complex patient case.

Findings

Left upper lobectomy resolved persistent hemoptysis in a patient with Loeys-Dietz syndrome.

Pathology confirmed the presence of a bronchiolo-arterial fistula.

No recurrence of hemoptysis was observed after 2 years of follow-up.

Abstract

Bronchiolo-arterial fistulae are rare occurrences that can lead to hemoptysis. In general, persistent hemoptysis has a broad range of causes and management options. Surgery is often used in cases where conservative approaches have failed. In this case study, we present a 43-year-old woman with Loeys-Dietz syndrome, a connective tissue disorder, who developed chronic persistent hemoptysis after multiple aortic operations. The hemoptysis did not resolve with antibiotics, corticosteroids, and coil embolization. Based on multidisciplinary consensus, a left upper lobectomy was performed, with no recurrence of hemoptysis after 2 years of follow-up. Pathology revealed a bronchiolo-arterial fistula.

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