title: A rare case of sinus of valsalva-right atrial fistula secondary to an abscess perforation from underlying aortic valve endocarditis.
abstract: Sinus of Valsalva-right atrial fistulas are abnormal connections between the aorta and the right atrium, and present challenging surgical conditions. An extremely rare etiology of aorto-right atrial fistula is infective endocarditis. This case report presents a 21 year old Caucasian female patient who had native aortic valve Staphylococcus aureus endocarditis complicated by sinus of Valsalva abscess perforation associated with an acute heart block, an aorto-right atrial fistula, severe heart failure, and cardiogenic shock. She underwent emergent aortic valve replacement and complex sinus of Valsalva fistula pericardial patch reconstruction and repair. This case report further explores the advantages and disadvantages of different valves for different patient populations, and evaluates the patient's prosthesis mismatch and effective orifice area.
authors.affiliation: University of Central Florida, College of Medicine, Orlando, FL, USA. elizabethjohn17@gmail.com.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: John
authors.forename: Joseph
authors.initials: J
authors.lastname: Boyer
authors.forename: Bradford
authors.initials: B
authors.lastname: Ledzian
authors.forename: Howard
authors.initials: H
authors.lastname: Steward
authors.forename: Richard
authors.initials: R
authors.lastname: Moro
authors.forename: Hartmuth B
authors.initials: HB
authors.lastname: Bittner
mesh_terms: D000038:Abscess / Q000382:microbiology*; D001021:Aortic Valve / Q000382:microbiology; D004697:Endocarditis, Bacterial / Q000150:complications / Q000382:microbiology; D005260:Female; D005402:Fistula / Q000209:etiology* / Q000382:microbiology; D006325:Heart Atria; D006331:Heart Diseases / Q000382:microbiology; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D012422:Rupture, Spontaneous; D012850:Sinus of Valsalva; D013203:Staphylococcal Infections / Q000150:complications / Q000382:microbiology; D013211:Staphylococcus aureus; D015819:Substance Abuse, Intravenous / Q000150:complications; D055815:Young Adult