Aortic root to left-atrial fistula after aortic valve replacement: A rare complication and its intraoperative management

Abstract

Aorto-atrial fistula is a rare complication of prosthetic aortic valve replacement (AVR) and most of them have been diagnosed as a late complication. We present a case of this unusual complication after AVR. Intraoperative transoesophageal echocardiography identified and diagnosed this rare and potentially disastrous surgical complication and confirmed adequacy of its surgical repair.

Transcatheter closure of an aortoatrial fistula following a surgical aortic valve replacement

“…Aorto‐atrial fistula is a rare complication of aortic valve surgery. Risk factors for postoperative AAF described in the literature included infected tissue before valve replacement, connective tissue abnormalities, extensive aortic annular debridement, and inadvertent injury to the atrial wall during dissection, and oversized aortic prostheses . Surgery is the standard treatment, but is associated with significant morbidity.…”

“…Risk factors for postoperative AAF described in the literature included infected tissue before valve replacement, connective tissue abnormalities, extensive aortic annular debridement, and inadvertent injury to the atrial wall during dissection, and oversized aortic prostheses. [5][6][7] Surgery is the standard treatment, but is associated with significant morbidity. Our patient developed an iatrogenic AAF after aortic valve replacement, likely due to injury of the base of the right atrial wall during aortotomy closure.…”