A Case of Aorto-Right Atrial Fistula Following Acute Type A Dissection Repair

Yasunori Yakita	Kenji Mogi	Kaoru Matsuura
Manabu Sakurai	Takashi Ogasawara and Yoshiharu Takahara

（Division of Cardiovascular Surgery, Heart and Vascular Institute, Funabashi Municipal Medical Center, Funabashi, Japan）

Patients with an aortic root pseudoaneurysm communicating to the right atrium are rare. A 67-year-old woman underwent ascending aorta and total aortic arch replacement for acute type A aortic dissection at our institute 9 years prior to the current presentation. She was transported to our emergency department with complaints of chest pain, palpitations, and cold sensation. A continuous murmur was heard at the right sternal margin. Contrast-enhanced computed tomography（CT）and ultrasonic cardiography showed a huge pseudoaneurysm at the proximal anastomotic site and an aorto-right atrial fistula. Ascending aortic replacement with concomitant direct closure of the fistula was successfully performed. The patient was discharged in good condition on the 14th postoperative day. Careful follow-up with CT is important after acute type A aortic dissection repair.　

 

Jpn. J. Cardiovasc. Surg. 44:56-58（2015）

Keywords：pseudoaneurysm;aorto-right atrium fistula;aortic dissection;total arch replacement;gelatin-resorcin folmaldehyde glue