Aortopulmonary Artery Fistula Research Articles

Aorto-pulmonary artery fistula with Laubry-Pezzi syndrome: A diagnostic enigma

Usually diagnosed post-mortem, aortopulmonary artery fistula is an exceptionally rare and often highly lethal condition. Here, we present a unique case of a 29-year-old woman with no history of aortic aneurysm or previous aortic surgery, referred for surgical management of Laubry-Pezzi syndrome in whom an aorto-pulmonary artery fistula bridging the ascending aorta and the main pulmonary artery was discovered intra operatively. The patient was successfully managed with an uneventful postoperative recovery. Our case outlines the inaugural reported occurrence of an aortopulmonary artery fistula coinciding with Laubry-Pezzi syndrome. Unique features include subtle onset of heart failure over months due to occult left ventricular volume overload, challenging diagnosis alongside known intracardiac shunts, emphasizing the need for vigilance, and demonstration of successful surgical outcomes despite high morbidity and mortality.

Aortopulmonary artery fistula: A rare complication of balloon dilatation of the pulmonary artery.

Acquired aortopulmonary fistula (APF) in the setting of repaired congenital heart disease is extremely rare but potentially fatal, so timely diagnosis and treatment are critical. We present a case of an 8-year-old female with a history of complex Taussig-Bing anomaly, who underwent an arterial switch procedure with LeCompte maneuver and ventricular septal defect closure early in life. The patient developed neopulmonary stenosis and branch pulmonary artery (PA) stenosis, for which she underwent patch augmentation and balloon dilatation of the left PA. The patient presented with a fistula between the ascending aorta and the left branch PA, confirmed by echocardiography and cardiac catheterization. She underwent repair of the APF with a homograft patch reconstruction of the ascending aorta.

Pulmonary Artery Dissection Associated With Aortopulmonary Artery Fistula

A 62-year-old man with multiple medical comorbidities, including a 180 pack-year history of smoking and severe chronic lung disease, presented with shortness of breath requiring immediate intubation. He was found to have a 7.1-cm aortic arch aneurysm with an aortopulmonary artery fistula, severe right ventricular dysfunction, and pulmonary artery dissection originating at the level of the fistula (Figure 1). Given his prohibitive medical profile, a less invasive surgical option was considered. He underwent vascular plug placement across the fistula and endovascular aortic repair with in situ laser fenestration and supraaortic vessel branch stenting.

Diagnosis and Management of Fontan Failure Secondary to Aortopulmonary Artery Fistula

Diagnosis and Management of Fontan Failure Secondary to Aortopulmonary Artery Fistula

Aorto-Pulmonary Artery Fistula Following Aortic Valve Replacement: A Diagnostic Dilemma

Aorto-pulmonary artery fistula is a rare and lethal occurrence after thoracic surgery and aortic aneurysms. Here we present a rare occurrence of acute aorto-pulmonary artery fistula in outpatient department in a follow up patient of aortic valve replacement and discuss challenges faced in diagnosis, etiopathogenesis and management.

Post-Traumatic Aortic Arch Aneurysm Complicated by Aorto-Pulmonary Fistula.

We report a rare case of presumed post-traumatic aortic arch aneurysm complicated by an aorto-pulmonary artery fistula. Contrast-enhanced computed tomographic pulmonary angiography completed by dynamic cardiac magnetic resonance imaging allowed adequate preoperative visualization of an 8-mm large fistula between the aneurysm and the left pulmonary artery. The patient underwent successful total aortic arch replacement and closure of the fistula using a patch.

Aortopulmonary Artery Fistula: Ruptured Aneurysm of the Distal Aortic Arch into the Pulmonary Artery

Aortopulmonary artery fistula is uncommon, but the clinical outcome is often lethal. A 76-year-old man with a history of acute thoracic aortic dissection 6 years previously was admitted with dyspnea. A chest x-ray showed pleural effusion and pulmonary congestion. Transthoracic echocardiography revealed preserved systolic function, but continuous and abnormal flow from the distal aortic arch into the pulmonary artery (PA). Transesophageal echocardiography (TEE) in the Doppler color-flow mode demonstrated a left-to-right shunt between a large distal aortic arch aneurysm and the left PA via an aortopulmonary fistula and a pressure gradient across the shunt of 56 mmHg. Contrast-enhanced computed tomography showed that the aneurysm compressed the PA. Aortography also revealed a large distal aortic arch aneurysm and almost simultaneous contrast enhancement of the aorta and the PA. Right-heart catheterization showed a significant increase in oxygen saturation between the right ventricle and the PA. A left-to-right shunt due to a distal aortic arch aneurysm rupturing into the left PA was diagnosed based on these findings. TEE was very helpful in confirming the presence and precise location of the fistula.

Double congenital fistulae with aneurysm diagnosed by combining imaging modalities.

Congenital coronary pulmonary artery fistula (CAF) is rare, and systemic-to-pulmonary artery fistula (SPAF) is even more so. Furthermore, congenital coronary pulmonary fistula associated with congenital SPAF is extremely rare. As far as we know, CAF and SPAF connected with an aneurysm have not been described very often. We described an 83-year-old woman with an aneurysm originating from a CAF connected to an aortopulmonary artery fistula. Chest radiography revealed a shadow at the left edge of the heart line. Multi-detector-row computed tomography (MDCT) with contrast enhancement and coronary cine angiography revealed that the shadow was an aneurysm connected to a tortuous fistula at the left anterior descending coronary artery. The aneurysm was formed by congenital coronary pulmonary and aortopulmonary artery fistulae. Echocardiography revealed predominantly systolic blood flow in the fistula from the left anterior descending coronary artery (LAD). Although neither MDCT, echocardiography nor coronary angiography alone could provide a comprehensive image of the anomaly, including the hemodynamics in the fistulae and their relationship with surrounding organs and tissues, their combination could provided important facts the led to a deeper understanding of this very uncommon occurrence.

Percutaneous Embolization of Vascular Fistulas Using Coils or Amplatzer Vascular Plugs

A great variety of different types of vascular fistula are referred to cardiac catheterization laboratories for diagnosis and percutaneous occlusion. In addition, a wide range of devices is available for treating them percutaneously. The objectives of this study were to assess the usefulness and difficulty of treating vascular fistulas percutaneously using controlled-release coils or Amplatzer vascular plugs and to report on the complications and overall outcomes observed with these two devices. Retrospective review of percutaneous embolizations performed from January 2004 through June 2008. In total, 51 vascular fistulas in 30 patients aged from 6 days to 28 years (mean, 8.4 years) underwent successful embolization. The underlying diagnoses were: 27 venous collaterals in 16 patients after the Glenn procedure, four surgical (i.e. Blalock-Taussig) fistulas, 11 pulmonary arteriovenous fistulas in three patients, two aortopulmonary collateral arteries in two patients, one venous collateral in a patient who underwent the Fontan procedure, one aortopulmonary artery fistula in a patient with Scimitar syndrome, one coronary arteriovenous fistula, three systemic arteriovenous fistulas in a newborn, and one fistula from the left atrium to the superior vena cava after the repair of anomalous pulmonary venous return. The lesions were treated percutaneously using 34 vascular plugs and 19 coils. Vascular fistulas can be occluded percutaneously with good Small fistulas can be closed using coils, while vascular plugs are preferable for large lesions. Both devices are highly effective as occluders and no particular difficulty or significant complication was observed.

A case report of thoracic aneurysm with aortopulmonary artery fistula

Rupture of an aortic aneurysm into the pulmonary artery is a rare and often a fatal event. This complication results in the development of an acute left to right shunt, volume overload, and rapid right heart deterioration. We describe a case of thoracic aortic aneurysm in whom the diagnosis of a communication with the pulmonary artery was made on the basis of transthoracic echocardiography.

Acquired aorto-pulmonary artery fistula following proximal aortic surgery

A 56-year-old man developed left heart failure secondary to left to right shunt due to acquired aorto-pulmonary artery (PA) fistula. He had previously undergone aortic root replacement for streptococcal aortic valve endocarditis. A modified strategy involving interventional radiology and surgical technique was employed to deal with this complex surgical challenge. A balloon catheter was placed in the right PA to enable fistula occlusion during cardiopulmonary bypass followed by repair using cardiopulmonary bypass and circulatory arrest.

Endovascular Repair of an Aortopulmonary Artery Fistula with Use of Controlled-release Coils

Aortopulmonary artery fistula is traditionally treated surgically. The present case report describes endovascular repair of an aortopulmonary artery fistula in a patient in whom two thoracotomies had been performed. The fistula occurred at the site of a pseudoaneurysm from the proximal anastomosis of a graft placed to treat a type B aortic dissection. Two controlled-release endovascular coils were positioned across the fistula, resulting in immediate closure. The fistula remains closed with resolution of the pseudoaneurysm after more than 3 years of follow-up.

Surgical Treatment of an Aortopulmonary Artery Fistula Complicating a Syphilitic Aortic Aneurysm

Spontaneous rupture of an aortic aneurysm into the pulmonary artery is unusual and is rarely reported in the literature. The case of a patient with a syphilitic aneurysm of the ascending aorta perforated into the pulmonary artery is presented. In an attempt to define the best surgical treatment for this complication the literature has been comprehensively reviewed.

Surgical treatment of an aortopulmonary artery fistula complicating a syphilitic aortic aneurysm

Spontaneous rupture of an aortic aneurysm into the pulmonary artery is unusual and is rarely reported in the literature. The case of a patient with a syphilitic aneurysm of the ascending aorta perforated into the pulmonary artery is presented. In an attempt to define the best surgical treatment for this complication the literature has been comprehensively reviewed.

Aorto-pulmonary artery fistula: An unusual complication of ascending aortic aneurysm

We report an unusual outcome of an ascending aorta aneurysm ruptured into the main pulmonary trunk. After successful emergency repair, an acute respiratory distress syndrome developed perioperatively and complicated the postoperative period. The patient could not be weaned from mechanical ventilation for a long time. The patient was discharged on the 62nd day of admission in good condition.

Compression of Pulmonary Artery by Aortic Aneurysm

ANEURYSMS of the ascending aorta may involve the main pulmonary artery or its branches by compression or by rupture and formation of an aortopulmonary artery fistula. While the diagnosis may be suggested from the chest roentgenogram, large midline ascending aortic aneurysms may be present yet not radiologically detectable. Diagnosis often requires pulmonary arteriography with visualization of the levophase as described herein. Report of a Case A 67-year-old woman had severe rightsided pleuritic chest pain, dyspnea, and hemoptysis for three days. The patient had been receiving warfarin sodium (Coumadin) for phlebitis but was unreliable in taking her medications. Her history included cancer of the bladder with bone metastasis and rheumatic heart disease. During physical examination, the patient was an anxious, diaphoretic woman in severe respiratory distress with considerable splinting of the right thorax. Her respirations were 24/min and blood pressure was 170/80 mm Hg. Breath sounds at the right base were

Recurrent aortopulmonary artery fistula.

Buxton, B. F., and Cooley, D. A. (1973). Thorax, 28, 521-525. Recurrent aortopulmonary artery fistula. The case report is presented of a patient who underwent successful repair of a recurrent fistula between the aorta and the pulmonary artery secondary to an atherosclerotic aneurysm of the ascending thoracic aorta. The fistula was situated between the proximal part of the ascending aorta and the proximal part of the main pulmonary artery and was associated with aortic incompetence together with pulmonary valvular stenosis and incompetence. The repair involved prosthetic replacement of both the pulmonary and aortic valves, the main pulmonary artery, and the ascending thoracic aorta.