Aorto-Left Atrial Fistula after Aortic Valve Replacement : a Rare Complication
- VernacularTitle:大動脈弁置換術後急性期に無冠動脈洞から左心房への短絡を発症した1例
- Author:
Tomonori OCHIAI
1
;
Tetsuro UCHIDA
1
;
Yoshinori KURODA
1
;
Atsushi YAMASHITA
1
;
Eiichi OHBA
1
;
Shingo NAKAI
1
;
Kimihiro KOBAYASHI
1
;
Mitsuaki SADAHIRO
1
Author Information
- Keywords: aortic valve replacement; sinus of Valsalva-left atrium fistul
- From:Japanese Journal of Cardiovascular Surgery 2021;50(1):31-33
- CountryJapan
- Language:Japanese
- Abstract: A 60-year-old man underwent aortic valve replacement for aortic valve regurgitation, tricuspid valve annuloplasty, and coronary artery bypass grafting. Postoperative echocardiography revealed shunted flow from the noncoronary sinus of Valsalva into the left atrium. The pathogenesis of this complication is considered to be uncertain ; however, it might be due to some kind of intraoperative injury. Three weeks after the initial surgery, we reoperated to repair the aorto-left atrial fistula. According to the intraoperative findings, small slits were found on the left atrial surface close to the posteromedial side of the mitral valve and the noncoronary sinus of Valsalva. The fistula was closed with transmural mattress sutures. Post-operative echocardiography showed no shunt flow. Although an aorto-left atrial fistula is a rare complication after aortic valve replacement, reoperation might be mandatory if the shunt flow is considerable. Surgeons should keep in mind the possibility of intraoperative injury to surrounding structures when performing aortic valve replacement.
