Interdisciplinary Management of the Emergency Treatment in an Atrioesophageal Fistula

The atrioesophageal fistula is a fulminant complication of radiofrequency ablation in atrial fibrillation, with a mortality as high as 80%. Surgical approaches have been insufficiently dealt with in literature. Treating a 42-year-old male patient, we developed an interdisciplinary two-step concept: (1) resection of the affected third of the esophagus and closing of the atrial defect using cardiopulmonary bypass and cardioplegic cardiac arrest; and (2) a second surgery to restore gastrointestinal continuity after an adequate term. Our patient has fully recovered.