title: Type A dissection and fistula to right atrium after aortic valve replacement.
abstract: A 73-year-old man with a history of severe aortic regurgitation underwent aortic valve replacement with a bioprosthesis. Nine years later, he presented with heart failure and was diagnosed with chronic type A dissection and severe aortic stenosis. During surgery, a fistula from the ascending aortic aneurysm to the right atrium was found incidentally. Replacement of the aortic valve and ascending aorta were performed successfully. The fistula was closed with sutures. The patient was discharged uneventfully on postoperative day 16.
authors.affiliation: Cardiovascular Center of Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Ming-Yuan
authors.initials: MY
authors.lastname: Kang
authors.affiliation: Cardiovascular Center of Taichung Veterans General Hospital, Taichung, Taiwan season@vghtc.gov.tw.
authors.forename: Shih-Rong
authors.initials: SR
authors.lastname: Hsieh
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001014:Aortic Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000209:etiology; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D000072226:Computed Tomography Angiography; D006325:Heart Atria / Q000000981:diagnostic imaging; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006333:Heart Failure / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D061330:Multidetector Computed Tomography; D012086:Reoperation; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery
keywords: Aneurysm; Aorta; Aortic valve; Fistula; Heart atria; Heart valve prosthesis implantation; dissecting