title: Percutaneous closure of complex paravalvular aortic root pseudoaneurysm and aorta-cavitary fistulas.
abstract: Native aortic valve or its prosthetic valve endocarditis can extend to the adjacent periannular areas and erode into nearby cardiac chambers, leading to pseudoaneurysm and aorta-cavitary fistulas respectively. The later usually leads to acute cardiac failure and hemodynamic instability requiring an urgent surgical intervention. However rarely this might pass unnoticed and the patient might present later with cardiac murmur. Percutaneous device closure of aortic pseudoaneurysm, ruptured sinus of Valsalva aneurysm, aorta-pulmonary window, paravalvular leaks, and aorta-cavitary fistula have been reported. We present a 59-year-old female who developed a large aortic root pseudoaneurysm with biventricular communication aorta-cavitary fistulas presenting late following aortic prosthetic valve endocarditis. She underwent successful percutaneous device closure of her pseudoaneurysm and aorta-cavitary fistulas using two Amplatzer Duct Occluders. This case illustrates a challenging combination of aortic root pseudoaneurysm and biventricular aorta-cavitary fistulas that was successfully treated with percutaneous procedure.
authors: Senior Consultant, Department of Pediatric Cardiology, Royal Hospital, Muscat 111, Oman.
authors: Salim
authors: S
authors: Al-Maskari
authors: Senior Specialist, Department of Adult Congenital Heart Disease, Royal Hospital, Muscat 111, Oman. Electronic address: prashanthp_69@yahoo.co.in.
authors: Prashanth
authors: P
authors: Panduranga
authors: Senior Consultant, Department of Pediatric Cardiology, Royal Hospital, Muscat 111, Oman.
authors: Abdullah
authors: A
authors: Al-Farqani
authors: Senior Consultant, Department of Pediatric Cardiology, Royal Hospital, Muscat 111, Oman.
authors: Eapen
authors: E
authors: Thomas
authors: Senior Consultant, Department of Cardiovascular Surgery, Royal Hospital, Muscat 111, Oman.
authors: John
authors: J
authors: Velliath
mesh_terms: D017541:Aneurysm, False / Q000150:complications / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000601:surgery*; D006328:Cardiac Catheterization / Q000379:methods*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006352:Heart Ventricles / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D055989:Septal Occluder Device; D012850:Sinus of Valsalva / Q000601:surgery*; D016157:Vascular Fistula / Q000150:complications / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods*
keywords: Aorta-cavitary fistula; Device closure; Endocarditis; Pseudoaneurysm