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Updated: Jul 16, 2026
07:41
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
[Left ventricular-right atrial communication resulting from infective endocarditis]
Kozo Fukui1, J Kanazawa, T Kawamura
1Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|March 14, 2007
Summary
This case report details a rare acquired left ventricular-right atrial communication caused by infective endocarditis. Prompt diagnosis via echocardiography and surgical closure led to an uneventful recovery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Infectious Diseases
Background:
- Infective endocarditis can lead to severe valvular damage and complications.
- Aortic regurgitation is a common manifestation of infective endocarditis.
- Congestive heart failure can arise from significant valvular dysfunction.
Observation:
- A 57-year-old male presented with severe congestive heart failure secondary to aortic regurgitation from infective endocarditis.
- Preoperative echocardiography revealed severe aortic, mitral, and tricuspid regurgitations.
- Intraoperative transesophageal echocardiography identified a left ventricular-right atrial shunt at the atrioventricular membranous septum.
Findings:
- The fistula originated below the right coronary cusp-non-coronary cusp commissure and above the tricuspid annulus septal leaflet.
- The left ventricular-right atrial communication was successfully closed with a mattress suture.
- Simultaneous procedures included aortic valve replacement and mitral/tricuspid ring annuloplasty.
Implications:
- This case highlights the importance of meticulous echocardiographic evaluation for shunts in infective endocarditis.
- Early detection and surgical intervention are crucial for managing complex cardiac complications.
- Effective treatment of infective endocarditis-related fistulas can lead to favorable patient outcomes.
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