title: Aorto-Right Atrial Fistula After Sutureless Valve Implantation.
abstract: Aortic valve replacement with sutureless valves has many potential applications including in redo surgery, minimally invasive scenarios, and heavily calcified aortic roots. Herein we report a case of the development of an aorto-right atrial fistula after replacement of a Medtronic Freestyle stentless subcoronary bioprosthesis (Medtronic Inc, Minneapolis, MN) with a Perceval sutureless valve (LivaNova PLC, London, UK). This eventually necessitated repair with repeat surgery and aortic valve replacement with a stented valve. For patients with failing stentless bioprostheses returning for reintervention, we suggest removal of only Freestyle leaflet tissue without supra-annular debridement to avoid weakening of the native root tissue.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
authors.forename: Jessica G Y
authors.initials: JGY
authors.lastname: Luc
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada.
authors.forename: Michiko
authors.initials: M
authors.lastname: Maruyama
authors.affiliation: Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada; Department of Anesthesiology, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Surita
authors.initials: S
authors.lastname: Sidhu
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Mazankowski Alberta Heart Institute, Edmonton, Alberta, Canada; Alberta Transplant Institute, Edmonton, Alberta, Canada; Canadian National Transplant Research Program (CNTRP), Edmonton, Alberta, Canada. Electronic address: jayan@ualberta.ca.
authors.forename: Jayan
authors.initials: J
authors.lastname: Nagendran
mesh_terms: D000368:Aged; D001011:Aorta / Q000473:pathology / Q000601:surgery; D001021:Aortic Valve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects; D005260:Female; D006325:Heart Atria / Q000473:pathology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000379:methods; D006801:Humans; D012086:Reoperation / Q000379:methods; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000601:surgery