title: Cardiogastric fistula occurring 9 years after resection of left ventricular aneurysm.
abstract: An 83-year-old man, 9 years after repair of a postinfarction aneurysm of the left ventricle, developed fever, anemia, and congestive heart failure. Extensive evaluation of the gastrointestinal tract revealed no evidence of ulcer disease. While in the hospital, he developed massive hematemesis and melena and died 2 days later. At autopsy, a communication existed between a left ventricular pseudoaneurysm and the stomach to form a cardiogastric fistula. Infection of the left ventricular pseudoaneurysm may have precipitated the gastric perforation. This represents an extremely rare late complication of aneurysmectomy procedures and, to our knowledge, is the first case to be reported in the absence of primary gastrointestinal pathology.
authors.affiliation: Division of Pathology, Mayo Clinic, Rochester, MN 55905.
authors.forename: J P
authors.initials: JP
authors.lastname: Grande
authors.forename: P A
authors.initials: PA
authors.lastname: Pellikka
authors.forename: W D
authors.initials: WD
authors.lastname: Edwards
authors.forename: F J
authors.initials: FJ
authors.lastname: Puga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000209:etiology; D005402:Fistula / Q000209:etiology*; D005747:Gastric Fistula / Q000209:etiology*; D006322:Heart Aneurysm / Q000601:surgery*; D006331:Heart Diseases / Q000209:etiology*; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D012008:Recurrence