Aorto-pulmonary fistula: a rare acquired lesion

Rupture of thoracic aortic aneurysms usually result in death from tamponade. Rarely does fistulous formation between the aorta and pulmonary artery complicate rupture. Such a complication results in the development of an acute left to right shunt. Although many previous reports occur in the literature only 10 include surgical management of an acquired aortic-pulmonary fistula. Two cases are presented with a description of their surgical management and outcome. Both these patients had previously undergone aortic valve replacement in the distant past for aortic regurgitation. These were the only 2 cases found in a review of 890 aortic valve replacements in Papworth Hospital over a 10 year period from 1975. The sicker of the two patients died during the operation and the second made a prompt recovery, succumbing a few years later to a cerebro-vascular accident.