Roof patch repair of an aortoduodenal fistula resulting from suture line failure in an aortic prosthesis

A unique method of managing aortoduodenal fistula due to proximal suture line failure eight years after resection of an aortic aneurysm is presented. A roof patch of woven Dacron was employed in the repair rather than resection and replacement of the entire prosthesis. Immediate operation is recommended for the patient presenting with the “herald bleed” of aortointestinal fistula after prosthetic aortic replacement.