title: Aorto-right atrial fistula following acute type A aortic dissection repair.
abstract: This report describes a rare case of aorto-right atrial fistula caused by rupture of a huge pseudoaneurysm that developed at the proximal aortic anastomotic site after total aortic arch replacement for acute type A aortic dissection. Preoperative aortography revealed that the fistula communicated with the right heart, but it was intraoperative Doppler transesophageal echocardiography that confirmed its course into the right atrium. Repeat total aortic arch replacement with concomitant direct closure of the fistula was performed successfully. The underlying cause of the pseudoaneurysm was the dehiscence of sutures at the proximal aortic anastomotic site, probably due to gelatin-resorcin-formaldehyde glue.
authors.affiliation: First Department of Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan. kazuchi@fj9.so-net.ne.jp
authors.forename: Kazuchika
authors.initials: K
authors.lastname: Suzuki
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Kazui
authors.forename: Abul Hasan Muhammad
authors.initials: AH
authors.lastname: Bashar
authors.forename: Katsushi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Terada
authors.forename: Naoki
authors.initials: N
authors.lastname: Washiyama
mesh_terms: D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000601:surgery*; D017541:Aneurysm, False / Q000150:complications / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications* / Q000601:surgery; D001027:Aortography; D019917:Blood Vessel Prosthesis Implantation; D002315:Cardiopulmonary Bypass; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D005402:Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006325:Heart Atria / Q000002:abnormalities / Q000601:surgery; D006801:Humans; D012086:Reoperation