Iatrogenic aorto-right ventricular fistula after transcatheter pulmonary valvuloplasty

We present an adult case of iatrogenic aorto-right ventricular fistula that developed after percutaneous transcatheter pulmonary valvuloplasty for pulmonary valve stenosis using Mustang® double balloons following definitive repair of double outlet right ventricle. At outpatient follow-up, an abnormal shunt between the aortic root and the right ventricular outflow tract was detected by echocardiography and enhanced computed tomography. The ratio of pulmonic to systemic blood flow was measured at 1.64 by cardiac catheterization. We successfully performed patch closure of the aorto-right ventricular fistula, concomitant with pulmonary valve replacement and tricuspid valvuloplasty.