Fish bone in oesophagus into aorta

A 70 year old presented with a history of painful swallowing for a week. and constitutional symptoms that started after eating a fish dinner when they felt like a fish bone "stuck" half way down!

CT scan reveals a mediastinal abscess around the oesophagus. Contrast is seen extravasating from the aorta into the mediastinum, and into the lumen of the oesophagus. A right thoracotomy was performed. The mediastinum was full of blood that  made dissection impossible. CPB had to be established RA via opening the pericardium to ascending aorta with a beating heart, so that the dissection could be completed. A defect was repaired on the arch of the aorta with 4-0 Prolene. An oesophagectomy had to be performed, as the oesophagus had been totally destroyed.