Aorta-Pulmonary Artery Communication Through the Lungs

Abstract

A case is reported of anomalous communication between the aorta and pulmonary artery by way of a pulmonary vascular mass. The left-to-right shunt was sufficient to cause typical circulatory dynamics and was demonstrated by cardiac catheterization and angiography. Complete cure was obtained by lobectomy.

Infective Endocarditis of the Aortic Valve Complicated by Aorta–To–Pulmonary Artery Fistula

“… 5 Physical examination findings of aortopulmonary fistula formation include a widened pulse pressure, a continuous cardiac murmur that has been described as “machinery-like” and sometimes localized to the left second and third intercostal spaces, and clinical signs of right ventricular volume overload due to the large degree of left-to-right shunting. 7 , 8 , 9 Similar to congenital aortopulmonary windows, patients with aortopulmonary fistulas can develop left ventricular dilation, pulmonary hypertension, and heart failure due to unrestricted shunting. TTE is commonly the first diagnostic modality, particularly using color flow Doppler interrogation to assess for continuous (systolic and diastolic) high-velocity flow.…”

“…Balloon dilation of pulmonary arteries has also been reported to cause aortopulmonary fistulas, possibly due to contact between an anatomically abnormal or dilated pulmonary artery and aorta in patients with histories of pulmonary artery stents or suture lines from previous Ross or arterial switch procedures 5 . Physical examination findings of aortopulmonary fistula formation include a widened pulse pressure, a continuous cardiac murmur that has been described as “machinery-like” and sometimes localized to the left second and third intercostal spaces, and clinical signs of right ventricular volume overload due to the large degree of left-to-right shunting 7, 8, 9. Similar to congenital aortopulmonary windows, patients with aortopulmonary fistulas can develop left ventricular dilation, pulmonary hypertension, and heart failure due to unrestricted shunting.…”