Publication

Acquired aortocameral fistula occurring late after infective endocarditis: An emblematic case and review of 38 reported cases

Said, S. A. M. & Mariani, M. A., 26-Aug-2016, In : World Journal of Cardiology. 8, 8, p. 488-495 8 p.

Research output: Contribution to journalReview articleAcademicpeer-review

AIM

To delineate the features and current therapeutic option of congenital and acquired aortocameral fistulas (ACF) secondary to iatrogenic or infectious disorders.

METHODS

From a PubMed search using the term "aortocameral fistula", 30 suitable papers for the current review were retrieved. Reviews, case series and case reports published in English were considered. Abstracts and reports from scientific meetings were not included. A total of 38 reviewed subjects were collected and analyzed. In addition, another case - an adult male who presented with ACF between commissures of the right and noncoronary sinuses and right atrium as a late complication of Staphylococcus aureus infective endocarditis of the AV - is added, the world literature is briefly reviewed.

RESULTS

A total of thirty-eight subjects producing 39 fistulas were reviewed, analyzed and stratified into either congenital (47%) or acquired (53%) according to their etiology. Of all subjects, 11% were asymptomatic and 89% were symptomatic with dyspnea (21 x) as the most common presentation. Diagnosis was established by a multidiagnostic approach in 23 (60%), single method in 14 (37%) (echocardiography in 12 and catheterization in 2), and at autopsy in 2 (3%) of the subjects. Treatment options included percutaneous transcatheter closure in 12 (30%) with the deployment of the Amplatzer duct or septal occluder and Gianturco coil and surgical correction in 24 (63%).

CONCLUSION

Acquired ACF is an infrequent entity which may occur late after an episode of endocarditis of the native AV. The management of ACF is generally by surgical correction but non-surgical device intervention has recently been introduced as a safe alternative.

Original languageEnglish
Pages (from-to)488-495
Number of pages8
JournalWorld Journal of Cardiology
Volume8
Issue number8
Publication statusPublished - 26-Aug-2016

    Keywords

  • Aortic-atrial shunt, Aortic-atrial fistulas, Infective endocarditis, Late complication, Surgical correction, RIGHT ATRIAL FISTULA, AMPLATZER SEPTAL OCCLUDER, AORTIC DISSECTION, TRANSCATHETER CLOSURE, VALSALVA ANEURYSM, RUPTURED SINUS, CLINICAL PRESENTATION, VALVE ENDOCARDITIS, RARE COMPLICATION, ASCENDING AORTA

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