Aorto-right atrial fistula following acute type A aortic dissection repair.

Abstract

This report describes a rare case of aorto-right atrial fistula caused by rupture of a huge pseudoaneurysm that developed at the proximal aortic anastomotic site after total aortic arch replacement for acute type A aortic dissection. Preoperative aortography revealed that the fistula communicated with the right heart, but it was intraoperative Doppler transesophageal echocardiography that confirmed its course into the right atrium. Repeat total aortic arch replacement with concomitant direct closure of the fistula was performed successfully. The underlying cause of the pseudoaneurysm was the dehiscence of sutures at the proximal aortic anastomotic site, probably due to gelatin-resorcin-formaldehyde glue.

• Authors: Kazuchika Suzuki, Teruhisa Kazui, Abul Hasan Muhammad Bashar, Katsushi Yamashita, Hitoshi Terada, Naoki Washiyama
• Journal: The Japanese journal of thoracic and cardiovascular surgery : official publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai zasshi (Jpn J Thorac Cardiovasc Surg) Vol. 54 Issue 11 Pg. 483-5 (Nov 2006) ISSN: 1344-4964 [Print] Japan
• PMID: 17144598 (Publication Type: Case Reports, Journal Article)

Topics

• Acute Disease
• Aged
• Aortic Dissection (surgery)
• Aneurysm, False (complications, surgery)
• Aortic Rupture (complications, surgery)
• Aortography
• Blood Vessel Prosthesis Implantation
• Cardiopulmonary Bypass
• Echocardiography, Doppler
• Echocardiography, Transesophageal
• Female
• Fistula (diagnostic imaging, etiology, surgery)
• Heart Atria (abnormalities, surgery)
• Humans
• Reoperation