Aorto-right Ventricular Fistula Research Articles

Impella Implantation as a Bridge to Surgery for Repair of Aorto-Right Ventricular Fistula Following Prosthetic Valve Endocarditis: A Case Report.

For patients with cardiogenic shock, delaying surgery with mechanical circulatory support is reported to yield better outcomes than emergency surgery. We report on an 82-year-old man diagnosed with vertebral osteomyelitis with concomitant infective endocarditis. Chest radiographs revealed a growing abscess, which resulted in an aorto-right ventricular fistula. Providing Impella support allowed for hemodynamic stabilization prior to surgery. The patient had an uneventful postoperative course and reported to be well in a follow-up 1 year later. Impella support can be used as a bridge to surgery for repairing fistulous tract formation in patients in cardiogenic shock.

Percutaneous device closure of an aorto-right ventricular outflow tract fistula after Bentall repair

A 43-years-old gentleman was diagnosed with a complex endoleak during evaluation of new onset NYHA class II exertional dyspnoea and heart failure 15 years after Bentall de-Bono repair with a 25 mm ...

LEFT TO RIGHT SHUNTING IN 60-YEAR-OLD PATIENT: ROLE OF PHYSICAL EXAMINATION

Post-tricuspid valve shunt lesions commonly present in childhood, presentation in adulthood is often complicated by pulmonary vascular disease (PVD) & impose a challenging clinical dilemma. 60 year-old male was transferred to our center with a diagnosis of aorto-right ventricular (Ao-RV) fistula

Transcatheter Aortic Valve-in-Valve Implantation Complicated by Aorto-Right Ventricular Fistula

We describe the case of a degenerative, sutureless bioprosthetic valve (BPV) with deformation and stent infolding in a patient with elevated surgical risk. Following discussion among the heart team, balloon valve fracture was performed to facilitate deployment of an aortic valve-in-valve transcatheter heart valve. Post-procedural imaging demonstrated BPV frame protrusion and contained annular rupture, which required operative intervention. (Level of Difficulty: Intermediate.)

Aorto-right Ventricular Fistula Closure after TAVR Guided by Intracardiac Echocardiography

Intracardiac echocardiography (ICE) has been historically used to guide device closure of interatrial communications and transeptal access for electrophysiological ablations.1 Recent advances in st...

AORTIC ROOT INFECTION WITH AORTOCAVITARY FISTULA: A RARE PRESENTATION OF NATIVE VALVE GEMELLA MORBILLORUM ENDOCARDITIS

Gemella morbillorum is a type of gram positive cocci that rarely causes infective endocarditis. We present a patient with native aortic and pulmonic valve endocarditis complicated by aorto-right ventricular fistula. A previously healthy, 33-year-old Spanish-speaking male who moved to the United

Destructive aortic root endocarditis involving pulmonary valve with aorto-right ventricular fistula.

Destructive aortic root endocarditis involving pulmonary valve with aorto-right ventricular fistula.

Infective endocarditis complicated by aortic dissection and aorto-right ventricular fistula

Infective endocarditis complicated by aortic dissection and aorto-right ventricular fistula

Infective endocarditis complicated by aortic dissection and aorto-right ventricular fistula

Infective endocarditis complicated by aortic dissection and aorto-right ventricular fistula

Aorto-right ventricular fistula following transcatheter aortic valve implantation using a 29 mm SAPIEN XT valve

An 83-year-old man with severe symptomatic aortic valve stenosis underwent transcatheter aortic valve implantation (TAVI) using a 29 mm SAPIEN XT valve. He was haemodynamically stable, but developed haemolytic anaemia....

Acute aortic dissection complicated by aorto-right ventricular fistula

Acute aortic dissection complicated by aorto-right ventricular fistula

Acute aortic dissection complicated by aorto-right ventricular fistula

Fistula A 68-year-old man with a history of systemic hypertension and chronic renal failure was admitted to our emergency department with chest pain and dyspnea. He had undergone tube graft replacement of the ascending aorta due to an acute type A aortic dissection 10 years previously. On admission he was hypertensive and tachycardic with a continuous murmur at the left upper sternal border. The electrocardiogram revealed nonspecific repolarization abnormalities and the transthoracic echocardiogram showed a severely dilated aortic root with an intimal flap and continuous turbulent flow from the aortic root toward the right ventricle (Figures 1 and 2). There was moderate aortic regurgitation caused by poor leaflet coaptation. The right chambers were slightly dilated and both ventricles had normal systolic function. Chest computed tomography confirmed aortic root dissection with a fistula between the aortic false lumen and right ventricle (Figures 3 and 4). The coronary arteries were

大動脈-右室交通を合併した感染性心内膜炎に対し大動脈基部置換術およびパッチ閉鎖術を施行した1例

大動脈-右室交通を合併した感染性心内膜炎に対し大動脈基部置換術およびパッチ閉鎖術を施行した1例

Undetected Aorto-RV Fistula With Aortic Valve Injury and Delayed Cardiac Tamponade following a Chest Stab Wound: A Case Report

IntroductionAlthough a few patients will survive after penetrating cardiac injuries, some of them may have unnoticeable intracardiac injuries. The combination of aorto-right ventricular fistula with aortic valve injury is rare.Case PresentationA 19 year-old man referred with an aorto-right ventricular fistula accompanied with aortic regurgitation and delayed tamponade following a stab in the chest. The patient was scheduled for fistula repair, aortic valve replacement and pericardectomy two months after trauma.ConclusionsTo prevent missing intracardiac injury and also late cardiac injury complications, in all pericordial stab wounds, serial clinical examinations and serial echocardiography should be performed. In addition, cardiac injuries should be repaired during the same hospital stay.

Repair of Aorto-Left Ventricular and Aorto-Right Ventricular Fistulas Following Prosthetic Valve Endocarditis

We report a case of a 77-year-old male who presented with an aorto-left ventricular fistula and an aorto-right ventricular fistula secondary to prosthetic valve endocarditis.

A Case of Aortic Dissection With Fistula From Aorta to Right Ventricle

Aorto-right ventricular fistula is a very rare complication of aortic dissection. We report a case of acute aortic dissection extending into the right ventricle as documented by echocardiography. The patient survived after successful surgical repair.

Aortic valve regurgitation with aorto-right ventricular fistula following penetrating cardiac injury

Aortic valve perforation due to a penetrating cardiac injury is extremely rare, especially with an associated shunt between the right ventricle and the aortic valve. We report here the case of an 18-year-old male, who after suffering a chest stab injury, was seen at another institution where he underwent an emergency left anterolateral thoracotomy and right ventricular suture. During the following 30 days, his course was torpid, complicated by a ventilator-associated pneumonia and heart failure with acute pulmonary edema. Workup confirmed the presence of an acute aortic regurgitation due to perforation of the right coronary leaflet with an interventricular shunt. After implementing appropriate medical treatment, the valve was replaced with a mechanical prosthesis and the shunt was closed with an autologous pericardial patch.

Three‐Dimensional Transthoracic Echocardiography in Identification of Aorto‐Right Atrial Fistula and Aorto‐Right Ventricular Fistulas

We report the case of a 72-year-old woman who developed new onset right ventricular failure after redo aortic valve replacement. The diagnosis of left to right shunt was initially made using two-dimensional transthoracic echocardiography (2DTTE) and 2D transesophageal echo with color Doppler (TEE). Definite diagnosis of aorto-right atrial and aorto-right ventricular fistula was made using three-dimensional transthoracic echocardiography (3DTTE) with color flow Doppler imaging. Early recognition and diagnosis of this rare surgical complication is imperative for prompt surgical repair of this lethal defect. 3DTTE should be utilized in cases of new onset heart failure with unclear etiology to diagnose unusual causes of this potentially fatal condition.

Early Echocardiographic Diagnosis of Aorto-Right Ventricular Fistula During Emergent Surgery for Penetrating Precordial Trauma

CASE REPORT A 20-year-old man was admitted in our trauma center after being stabbed with a small-bladed stiletto knife in the left hemithorax. The patient had no medical history. At the scene, the patient presented no hemodynamic or respiratory distress. Bleeding from the thoracic wound was moderate and no hemoptysis was found. During transportation to the hospital, the patient rapidly developed hemodynamic instability and received a continuous infusion of norepinephrine from the mobile medical team. At the admission to the hospital, the patient was alert and responsive, despite a very low-blood pressure (60/40 mm Hg). No other sign suggesting cardiac tamponade as distension of jugular vein or paradoxical pulse were present. The patient showed a 1.5-cm horizontal stab wound in the left parasternal region at 5 cm of sternum in the left-fourth intercostal space. A transthoracic echocardiography was immediately performed at the bedside showing circumferential pericardial effusion with diastolic right ventricular (RV) collapse indicating a cardiac tamponade. A median thoracotomy was performed, the pericardium was opened, and an important pericardial effusion was evacuated followed by a dramatic increase of blood pressure. A transmural injury of RV anterior free wall was closed. At the end of surgery the patient was stable, with no active bleeding. No thrill at palpation of the right ventricle could be detected. A transesophageal echocardiography (TEE) was performed showing a false signal jet (spectral folding in color Doppler with lowering of pulse repetition frequency for high frequencies caused by an acceleration of flow at the exit of the stenosis on the level of the fistula) in the RV outflow tract (Fig. 1). A mid esophageal atrioventicular long axis 130° view revealed a high-velocity jet between the aorta and the RV during the whole cardiac cycle. No aortic or tricuspid injury was observed (Fig. 2). The fistula was significant enough to require another immediate repair with cardiopulmonary bypass. Electromechanical arrest was achieved with antegrade cardioplegia. Two different lesions could be found and repaired: one was located at the right coronary sinus and the second one at posterior part of the right ventricle free wall. The initial follow-up was eventless. At day 13, physical examination revealed a new heart murmur leading to a new transthoracic echocardiography and a diagnosis of recurring aortoventricular fistula at the same location, probably due to inefficacy of the first sutures. A new intervention was equally performed by cardiopulmonary bypass and satisfactory result was checked by TEE examination. Hospital discharge was obtained at day 25 with good cardiac function recovery.

Aorto-right ventricular fistula presenting 10 years after aortic surgery as an acute coronary syndrome

MOTS CLES Syndrome coronarien aigu ; Fistule ; Scanner cardiaque An 82-year-old man with a history of aortic valve replacement with a Hancock bioprosthesis 10 years earlier was admitted for a suspicion of acute coronary syndrome (ACS). Initial physical examination revealed no persistent chest pain, normal haemodynamics, jugular venous distension and a precordial continuous murmur. An electrocardiogram displayed right bundle branch block and transient ST-depression in the inferolateral leads. Troponin Ic and C-reactive protein values were mildly elevated on blood test. Transthoracic echocardiography showed a normally functioning prosthesis, a normal left ventricle, a dilated right ventricle and a mild pulmonary hypertension. A fistula was found between the right sinus of Valsalva and the right ventricle, with a maximal flow velocity of 2.5m/s, suggesting a chronic process. The Qp/Qs ratio was 1.7. Transoesophageal echocardiography (Fig. 1A and B) showed two pseudoaneurysms at the previous aortotomy suture line. A defect located in the right-sided pseudoaneurysm wall was responsible for the fistula. No vegetation was noticed. Electrocardiogram-gated 64-slice computed tomography depicted the fistula surrounding the proximal portion of the right coronary artery (Fig. 1C and D), suggesting compression of this vessel, which might have accounted for the signs of an ACS. As the patient’s haemodynamics promptly deteriorated, he was urgently referred for cardiac surgery without