Left ventricular to right atrial fistula after aortic homograft replacement for endocarditis.
The treatment is described of a patient who had severe bacterial endocarditis with aortic valve destruction and septal abscess complicated by left ventricular to right atrial fistula 3 months after aortic homograft root replacement and septal debridement and repair. The status of the aortic homograft and anatomy of the fistula were defined precisely by echocardiography, making successful repair through a right atriotomy possible without disturbing the aortic homograft and the implanted coronary arteries.
Joyce
F S
FS
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio.
McCarthy
P M
PM
Stewart
W J
WJ
Tomford
J W
JW
Rehm
S J
SJ
Heupler
F A
FA
Trohman
R G
RG
D000038:Abscess / Q000000981:diagnostic imaging / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery*; D001705:Bioprosthesis; D003646:Debridement; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000000981:diagnostic imaging / Q000601:surgery*; D005402:Fistula / Q000000981:diagnostic imaging / Q000601:surgery*; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010496:Pericardium / Q000637:transplantation; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery*; D012086:Reoperation; D013290:Streptococcal Infections / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques; D014184:Transplantation, Homologous