title: [Left ventricular-right atrial communication resulting from infective endocarditis].
abstract: We report a rare case of acquired left ventricular-right atrial communication resulting from infective endocarditis. A 57-year-old male with aortic regurgitation due to infective endocarditis was referred to our hospital because of severe congestive heart failure. Preoperative transthoracic echocardiography showed aortic, mitral and tricuspid severe regurgitations. Intraoperative transesophageal echocardiography revealed left ventricular-right atrial shunt. The fistula was located at the atrioventricular membranous septum. The communication site from the left view was below the commissure between the right coronary cusp and non-coronary cusp, and from the right view was just above the tricuspid annulus of the septal leaflet. The fistula was closed directly with mattress suture and aortic valve replacement and both mitral and tricuspid ring annuloplasty were carried out simultaneously. The postoperative course was uneventful. It is important to inspect shunts carefully in echocardiography of infective endocarditis with massive regurgitations.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Fukui
authors.forename: J
authors.initials: J
authors.lastname: Kanazawa
authors.forename: T
authors.initials: T
authors.lastname: Kawamura
authors.forename: S
authors.initials: S
authors.lastname: Yamauchi
authors.forename: K
authors.initials: K
authors.lastname: Watanabe
authors.forename: S
authors.initials: S
authors.lastname: Taniguchi
authors.forename: K
authors.initials: K
authors.lastname: Daitoku
authors.forename: M
authors.initials: M
authors.lastname: Minakawa
authors.forename: Y
authors.initials: Y
authors.lastname: Suzuki
authors.forename: I
authors.initials: I
authors.lastname: Fukuda
mesh_terms: D001022:Aortic Valve Insufficiency / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging*; D005402:Fistula / Q000209:etiology*; D006325:Heart Atria; D006331:Heart Diseases / Q000209:etiology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative