Aorto-atrial fistula 10 days after dissection repair in giant cell arteritis

Active aortitis caused by giant cell arteritis occurs more commonly than has been previously appreciated, and ascending aortic dissection may occur despite medical therapy, without a preexisting aneurysm or ectasia. We report a case of acute type A aortic dissection in a patient already treated for giant cell arteritis. The aortic root was left intact during the initial surgery, but was completely removed 10 days later after an early postoperative aorto-atrial fistula. Complete removal of the aortic root (Bentall procedure) has been advocated in these patients to prevent late additional aortic complications.