Aortopulmonary Artery Fistula in Atherosclerotic Pseudoaneurysm Presenting with Congestive Heart Failure after Aortic Valve Replacement

Abstract

An exceptional case of a giant pseudoaneurysm of the atherosclerotic ascending aorta complicated by aor-topulmonary fistulization twelve years after aortic valve replacement is presented. The patient underwent successful surgical repair. In patients with a marked atherosclerotic thoracic aorta presenting with congestive heart failure and an acquired continuous systolo-diastolic murmur, aortopulmonary fistula should be considered and differentiated from ruptured sinus of valsalva aneurysm. Multi-slice computed tomography was the most useful diagnostic tool in planning surgical strategy and approach. Surgery is the treatment of choice for this serious albeit rare entity.

Key Words:

• Aorto-pulmonary fistula
• aortic valve replacement
• thoracic aortic aneurysm
• heart failure
• aortic surgery.

Additional information

Notes on contributors

A. Bol

Dr. A. Bol, M.D. Department of Cardiology, St Jan Hospital, Ruddershove 10, B-8000 Brugge, Belgium; Phone: + 32 50 45 26 70 Fax: + 32 50 45 26 79 E-mail: [email protected]