Aortocardiac fistulas complicating infective endocarditis.
This study sought to determine the clinical and echocardiographic features, surgical approach, and outcome of patients with infective endocarditis complicated with aortocardiac fistulas among a series of 346 consecutive cases between 1988 and 1998. Nine patients (2%) were found to have aortocardiac fistulas complicating infective endocarditis caused by highly pyogenic pathogens (4 patients had ruptured abscesses of the right sinus of Valsalva, 3 had fistulous communications from the left coronary sinus, and 1 had a fistulized abscess in the noncoronary sinus). Mortality in these patients was very high (55%), even when surgery was attempted early in the course of the disease and reconstructive procedures were implemented.
Cardiovascular Institute, Department of Microbiology, Institut d'Investigacions Biomèdiques August Pi I Sunyer-Hospital Clinic, University of Barcelona, Spain.
I
I
Anguera
G
G
Quaglio
J M
JM
Miró
C
C
Paré
M
M
Azqueta
F
F
Marco
C A
CA
Mestres
A
A
Moreno
J L
JL
Pomar
P
P
Mezzelani
G
G
Sanz
D000328:Adult; D000368:Aged; D001018:Aortic Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006331:Heart Diseases / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D016157:Vascular Fistula / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery