Aorto-tracheal fistulas are rare and highly lethal, with few reports of
successful surgical intervention. We present a 48 year old man with
aorto-tracheal fistula induced by radiation therapy for tracheal
squamous cell carcinoma. He presented with hemoptysis and chest pain and
workup revealed the aorta-tracheal fistula between the posterior aortic
arch and anterior distal trachea. He was emergently taken to surgery. To
our knowledge, this is the first report of an aorto-tracheal fistula
successfully treated with a transverse aortic arch replacement and
complex tracheal repair using autologous pericardium with an omental
buttress.