Aorta to right atrium fistula with congestive heart failure resulting from a patent Cabrol shunt affer repair of aortic dissection

Rosero, Hugo; Nathan, Paul E.; Rodney, Evens; Vasavada, Balendu C.; Sacchi, Terrence J.

doi:10.1016/0002-8703(94)90637-8

Cited by 8 publications

(5 citation statements)

References 6 publications

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“…Echocardiography 2 years after the surgery showed only moderate tricuspid regurgitation and the medial leaflet malfunction, which is the result of the aortic root–right atrial shunt and reconstruction of the central fibrous body. Although a report by Rosero et al 13 described a case of long-term shunt patency with detrimental consequences. In our case, the tricuspid regurgitation is moderate (about 1.2 cm 2 ), and the patient has not developed any symptoms.…”

Section: Discussionmentioning

confidence: 99%

Reoperation for ascending aorta aneurysm after double valve replacement in a Takayasu’s aortitis patient: a case report

Fan

Peng

et al. 2017

European Heart Journal - Case Reports

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Takayasu’s aortitis (TA) is a complicated disease. Surgical treatment, especially reoperation, can be difficult. Here, we report a case of reoperation for TA, which presented with three major complications (aortic aneurysm, valve detachment, and fistula) 3 years after surgical treatment. During the surgery, the aortic valve was reconsolidated and fixed to the mitral valve, the fistula was then repaired, and the aortic root was replaced with woven graft. Following an uncomplicated postoperative event, the patient was discharged at 24 days postoperatively. Follow-up echocardiography at 2 years showed no perivalvular leakage. In such reoperative cases, when double valve replacement is required, it may be better to proactively reconstruct the structure of the central fibrous body.

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Section: Discussionmentioning

confidence: 99%

Reoperation for ascending aorta aneurysm after double valve replacement in a Takayasu’s aortitis patient: a case report

Fan

Peng

et al. 2017

European Heart Journal - Case Reports

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“…Cabrol and colleagues commented that the periprosthetic-to-right atrial fistulas usually close soon after the operation [6]. The persistence of the fistula is most likely due to suture line dehiscence resulting in increased blood flow preventing the fistula from closing [7]. If the fistula becomes hemodynamically problematic, however, it can be surgically closed relatively easily [8].…”

Section: Discussionmentioning

confidence: 99%

“…Few persistent patent Cabrol shunts have been reported; Tosoratti and colleagues discussed a patient with a valve conduit detachment and patent surgical fistula 16 years after the procedure presenting with heart failure and severe pulmonary hypertension [9]. These few cases demonstrate that a patent Cabrol shunt should be included on the differential diagnosis for any patient presenting with a past history of cardiac surgery, a left-to-right shunt, and a continuous murmur [7]. …”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Ascending Aortic Aneurysm and Its Complications

Sran

Ferguson

et al. 2014

Case Reports in Vascular Medicine

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Ascending aortic aneurysms involving the proximal aortic arch, arising anywhere from the aortic valve to the innominate artery, represent various problems in which open surgery is generally required. Surgical options include excision of the aortic pathology or wrapping the aneurysm shell with an aortic Dacron graft. Intervention using the latter method can lead to extravasation of blood along the suture lines resulting in continuous bleeding within the periprosthetic space. The Cabrol technique was developed as a method for decompression of postoperative leaks by the formation of a conduit system from the periprosthetic space to the right atrium. The coronary ostia are anastomosed to a second graft in an end-to-end fashion, which is then anastomosed to the ascending aortic conduit side to side. The native aorta is then sewn around the prosthesis, hereby creating a shunt to drain anastomotic leakage. This shunt reduces postsurgical risk of pseudoaneurysm formation and normally closes a few days following surgery. We discuss the case of a patient who underwent Cabrol's variation and six months later was demonstrated to have a patent shunt.

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“…4,5 Usually, the shunt closes spontaneously but there are reports of an open Cabrol shunt causing heart failure because of a high left to right shunt fl ow. 6 Many cases of pseudoaneurysms between the wrapping aorta and the graft have also been reported; 7-9 however, an aneurysm-atrium fi stula causing severe heart failure as a result of high shunt fl ow is very unusual. Initially, we thought that the Cabrol shunt graft had reopened in our patient, but we found that it was totally occluded with no blood fl ow.…”

Section: Discussionmentioning

confidence: 99%

Aorto-Right Atrium Fistula Caused by Detachment After Bentall's Operation: Report of a Case

et al. 2007

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A 70-year-old woman was admitted to our hospital for treatment of right heart failure 16 years after undergoing Bentall's operation with a Cabrol shunt procedure. Various investigations showed detachment of the coronary artery and graft. We surmised that the heart failure was caused by a massive left to right shunt between a pseudoaneurysm of the wrapping aortic wall and the right atrium. Intraoperatively, we found a small fistula between the wrapping aortic wall and the right atrium, with complete closure of Cabrol shunt. We performed regrafting of the ascending aorta and reconstruction of the coronary ostium under cardiopulmonary bypass. The patient had an uneventful postoperative course. Detachment of the coronary ostium is a common long-term complication of Bentall's operation, but a Cabrol shunt between the wrapping aortic wall and the right atrium rarely causes congestive heart failure. A fistula between a pseudoaneurysm and the right atrium is even more unusual.

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Aorta to right atrium fistula with congestive heart failure resulting from a patent Cabrol shunt affer repair of aortic dissection

Cited by 8 publications

References 6 publications

Reoperation for ascending aorta aneurysm after double valve replacement in a Takayasu’s aortitis patient: a case report

Reoperation for ascending aorta aneurysm after double valve replacement in a Takayasu’s aortitis patient: a case report

Surgical Management of Ascending Aortic Aneurysm and Its Complications

Aorto-Right Atrium Fistula Caused by Detachment After Bentall's Operation: Report of a Case

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