Successful surgical management of an aortic arch aneurysm with acute aorto-pulmonary fistula.

Aortic arch aneurysm with acute aorto-pulmonary fistula is usually a postmortem diagnosis. Few reports of successful surgical management are noted. Despite the many advances in cardiac surgery over the last 30 years, the observed mortality rate for surgical correction has been very high. Early diagnosis and prompt surgical intervention using profound hypothermia and total circulatory arrest are essential to successful outcome.