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Case Reports
. 2014 Nov 18:2014:bcr2014207374.
doi: 10.1136/bcr-2014-207374.

A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

Rajendra Kumar Premchand  1 , Bolleneni Bhaskar Rao  2 , Kaustubh Partani  1
Affiliations
Case Reports

A rare case of acquired aortopulmonary fistula with bicuspid aortic valve: report of successful surgical repair

Rajendra Kumar Premchand et al. BMJ Case Rep. .

Abstract

An acquired aortopulmonary fistula is a rare and usually fatal phenomenon. Rarer still are reports of successful surgical repair of aortopulmonary fistulae. We present the case of a 48-year-old hypertensive man who presented with congestive cardiac failure. Examination revealed a bicuspid aortic valve and a large aneurysm of the arch of the aorta, which was communicating with the main pulmonary artery. The diagnosis of acquired aortopulmonary fistula was made using transthoracic echocardiography findings and confirmed by CT. The patient was successfully managed by surgery, with an uneventful postoperative recovery, with control of congestive cardiac failure. At 1-year follow-up, the patient had Class I symptoms.

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Figures

Figure 1
Figure 1
Chest X-ray revealing cardiomegaly with bilateral lung congestion/pulmonary oedema; aortic aneurysm of the arch of aorta is seen, causing a tracheal shift towards the right, represented by an arrow.
Figure 2
Figure 2
Transthoracic echocardiogram* showing a giant aneurysm at the arch of the aorta; colour Doppler study displaying the direction of blood flow from the aneurysm to the main pulmonary artery (*basal short axis view; A, aneurysm; LA, left atrium; PA, pulmonary artery; RA, right atrium).
Figure 3
Figure 3
CT scan displaying the contrast axial view of the aneurysm with connection to the main pulmonary artery; the solid arrow points to the connection and depicts the flow from the aneurysm to the pulmonary artery (A, aneurysm; PA, pulmonary artery).
Figure 4
Figure 4
Intraoperative image displaying a 1 cm fistula between the aorta and the pulmonary artery, represented by an arrow.
See this image and copyright information in PMC

References

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