Acquired aortopulmonary fistula: a case report
| Autor: | Osama Mahmoud, Amro Alsaid, Hadi Elias, Arsalan Rafiq |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Aorta
medicine.medical_specialty medicine.diagnostic_test business.industry Fistula Case Reports 030204 cardiovascular system & hematology medicine.disease Chest pain 03 medical and health sciences Aortic aneurysm 0302 clinical medicine medicine.artery Heart failure Ascending aorta Angiography Pulmonary artery cardiovascular system Medicine 030212 general & internal medicine Radiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Eur Heart J Case Rep |
| ISSN: | 2514-2119 |
| Popis: | Background Aortopulmonary fistula is a rare complication of ascending aorta pathology. Presentation is most commonly dramatic with acute onset chest pain or heart failure secondary to left to right shunting. We describe a patient with acquired aortopulmonary fistula who had an insidious onset of heart failure as his presenting complaint. We also highlight the utility of multimodality cardiac imaging in establishing the diagnosis. Case summary A 79-year-old male patient with a history of coronary artery bypass graft surgery and mechanical aortic valve replacement, 23 years prior, presented with exertional dyspnoea of 7 months duration. An initial workup that included transthoracic and transoesophageal echocardiography as well as coronary and bypass graft angiography failed to diagnose an acquired aortopulmonary fistula complicating an ascending aortic pseudoaneurysm. Upon referral to our institution, the correct diagnosis was suspected on off-axis transthoracic echocardiography. The fistula was subsequently confirmed, and the extent of ascending aorta pathology defined via a multimodality imaging approach that consisted of transoesophageal echocardiography and cardiac computed tomography. The patient underwent successful surgical repair and was discharged in a stable condition. Discussion Acquired aortopulmonary fistula is a rare clinical entity. We describe a patient who had an insidious presentation of heart failure and found to have a large ascending aortic aneurysm that eroded into the main pulmonary artery creating a fistulous communication. The diagnosis was delayed and required a high index of suspicion and multimodality cardiac imaging. |
| Databáze: | OpenAIRE |
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