Aorta-right atrial fistula: a rare complication of prosthetic aortic valvular endocarditis

Area of Science:

• Cardiology
• Cardiac Surgery
• Infectious Diseases

Background:

• Aortic valve endocarditis is a serious infection affecting heart valves.
• Aortic root abscesses are known complications, but intracardiac fistulas are uncommon.
• Prosthetic valve endocarditis presents unique challenges in diagnosis and management.

Observation:

• This report details a rare case of prosthetic valve endocarditis.
• The patient developed an aortic root abscess that subsequently ruptured.
• The rupture created a direct connection between the aorta and the right atrium.

Findings:

• An aortic-right atrial fistula was identified as a complication of the abscess.
• A highly mobile vegetative mass was observed within the right atrium.
• This fistula formation significantly altered the cardiac hemodynamics and clinical presentation.

Implications:

• This case underscores the potential for rare but severe complications from prosthetic valve endocarditis.
• Early recognition of intracardiac fistula formation is crucial for appropriate surgical and medical management.
• Understanding these rare fistulas can improve patient outcomes and guide future treatment strategies.