Minimally invasive video-assisted surgery for iatrogenic aortic root-to-right atrium fistula after incomplete percutaneous occlusion of patent foramen ovale: case report and review of the literature.
BACKGROUND
The foramen ovale remains patent in about 25% of the population. Paradoxical embolism through a patent foramen ovale (PFO) may produce ischemic events. The closure of a PFO may prevent recurrence of cerebrovascular events. Percutaneous closure of a PFO is now-a-days a standard procedure and it appears to carry a low rate of complications. A surgical approach, in some cases, may be needed.


METHODS
A patient underwent percutaneous closure of PFO. There was a residual shunt after the procedure and a fistula between the aortic root-to-right atrium was subsequently discovered. Surgery was carried out using a "Port-Access technique" through a right anterior minithoracotomy.


RESULTS
Postoperative course was uneventful. Complete obliteration of the fistula was achieved.


CONCLUSIONS
Minimally invasive surgery may be effective to treat PFO or even complications after previous percutaneous attempts of closure. An aesthetically acceptable conclusion, especially in young female patients, and a very low rate of morbidity may be accomplished.
Raffa
Giuseppe M
GM
Department of Cardiac Surgery, University of Pavia, Pavia, Italy. raffagiuseppe@yahoo.it
Pellegrini
Carlo
C
Lentini
Salvatore
S
Perrotta
Sossio
S
Tancredi
Fabrizio
F
Gaeta
Roberto
R
Viganò
Mario
M
D000328:Adult; D001011:Aorta / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D054092:Foramen Ovale, Patent / Q000601:surgery*; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D007049:Iatrogenic Disease; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020535:Video-Assisted Surgery