title: Aorto-right atrial fistula: Late complication of tricuspid valve infective endocarditis.
abstract: Abnormal connections between the ascending aorta and the cardiac chambers are rare, especially in the context of right-sided infective endocarditis (IE). Transthoracic echocardiography (TTE) with color-flow Doppler, transesophageal echocardiography (TEE), or both may be required for diagnosis. We present the case of a woman admitted with right-sided heart failure (HF) symptoms. She had a previous history of tricuspid valve IE 30 years ago. TTE and TEE revealed an aorto-right atrium fistula located just under the non-coronary cusp into the right atrium at the level of the previously affected tricuspid valve. The Patient refused surgery and was discharged home on HF medications. She has been stable for the last 3 years. The peculiarity of this case is the late symptomatic presentation of the aorto-atrial fistula and the unusual association to tricuspid valve IE.
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Villablanca
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Shashvat
authors.initials: S
authors.lastname: Sukhal
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Oscar
authors.initials: O
authors.lastname: Maitas
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Afiachuukwu
authors.initials: A
authors.lastname: Onuegbu
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Muñoz-Peña
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Ajay
authors.initials: A
authors.lastname: Joseph
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Carlos
authors.initials: C
authors.lastname: Requena
authors.affiliation: Pedro A Villablanca, Shashvat Sukhal, Oscar Maitas, Afiachuukwu Onuegbu, Juan M Muñoz-Peña, Ajay Joseph, Carlos Requena, Divyanshu Mohananey, Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL 60612, United States.
authors.forename: Divyanshu
authors.initials: D
authors.lastname: Mohananey
keywords: Aorto-cardiac fistula; Infective endocarditis; Tricuspid valve