title: Aorto-right atrial fistula secondary to rupture of an occluded old saphenous venous graft to right coronary artery.
abstract: We report a case of an acquired aorta-right atrial fistula, secondary to a ruptured proximal anastomosis of an old saphenous vein graft 12 years after a coronary artery bypass surgery, in a 57 year old patient with multiple cardiovascular risk factors. On admission, he presented with congestive heart failure and on examination a continuous murmur was detected on the right parasternal border. Catheterization showed a fistula from the proximal anastomosis of an occluded right coronary artery saphenous vein graft draining to the right atrium with a large left to right shunt. The fistula was successfully occluded by a percutaneous approach with a Life Tech duct occluder with complete resolution of heart failure. The patient was discharged one week afterwards. After a two-year follow-up, the fistula remained occluded.
authors: Instituto Modelo de Cardiología, Sagrada familia 359, Córdoba, Argentina.
authors: Carlos Sebastian
authors: CS
authors: Balestrini
authors: José Federico
authors: JF
authors: Saaibi
authors: Santiago Navas
authors: SN
authors: Ortiz
mesh_terms: D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D005402:Fistula / Q000175:diagnosis / Q000209:etiology; D006083:Graft Occlusion, Vascular / Q000150:complications* / Q000175:diagnosis; D006325:Heart Atria; D006331:Heart Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D012422:Rupture, Spontaneous; D012501:Saphenous Vein / Q000637:transplantation*; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology*
keywords: aorto-atrial fistula; cardiac catheterization; endovascular therapy; saphenous venous graft; transcatheter closure