An interesting case of an aortopulmonary artery fistula

“…[ 4 ] After accurate delineation of the anatomy, location, and size of the fistula is achieved, the patient can be treated by either open surgery, hybrid procedure, or endovascular stenting. [ 5 ] The risks of pulmonary hypertension, Eisenmenger syndrome, and congestive heart failure remain high in patients with large aortopulmonary fistulae. Patients with very small shunt lesions, such as this patient, may remain asymptomatic, however.…”

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confidence: 99%

What Flow is This!

Singh

Nanda

Mishra

et al. 2023

Annals of Cardiac Anaesthesia

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Acquired aortopulmonary fistula: a case report

Mahmoud

Elias

Rafiq

et al. 2020

European Heart Journal - Case Reports

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Background Aortopulmonary fistula is a rare complication of ascending aorta pathology. Presentation is most commonly dramatic with acute onset chest pain or heart failure secondary to left to right shunting. We describe a patient with acquired aortopulmonary fistula who had an insidious onset of heart failure as his presenting complaint. We also highlight the utility of multimodality cardiac imaging in establishing the diagnosis. Case summary A 79-year-old male patient with a history of coronary artery bypass graft surgery and mechanical aortic valve replacement, 23 years prior, presented with exertional dyspnoea of 7 months duration. An initial workup that included transthoracic and transoesophageal echocardiography as well as coronary and bypass graft angiography failed to diagnose an acquired aortopulmonary fistula complicating an ascending aortic pseudoaneurysm. Upon referral to our institution, the correct diagnosis was suspected on off-axis transthoracic echocardiography. The fistula was subsequently confirmed, and the extent of ascending aorta pathology defined via a multimodality imaging approach that consisted of transoesophageal echocardiography and cardiac computed tomography. The patient underwent successful surgical repair and was discharged in a stable condition. Discussion Acquired aortopulmonary fistula is a rare clinical entity. We describe a patient who had an insidious presentation of heart failure and found to have a large ascending aortic aneurysm that eroded into the main pulmonary artery creating a fistulous communication. The diagnosis was delayed and required a high index of suspicion and multimodality cardiac imaging.

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An interesting case of an aortopulmonary artery fistula

Cited by 3 publications

References 8 publications

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

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

What Flow is This!

Acquired aortopulmonary fistula: a case report

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