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Aorto-Left Atrial Fistula : A Reversible Cause of Acute Refractory Heart Failure FREE TO VIEW

Thomas P. Archer; Scott W. Mabee; Peter B. Baker; David A. Orsinelli; Carl V. Leier
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From the Division of Cardiology, the Ohio State University College of Medicine, Columbus

1997 by the American College of Chest Physicians

Chest. 1997;111(3):828-831. doi:10.1378/chest.111.3.828
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Fistulas between the aorta and left atrium, invariably a complication of aortic valvular endocarditis, are rare and infrequently diagnosed premortem. We describe a patient who presented with this entity and review the reports of five other patients for whom a diagnosis was made premortem. A number of causative organisms have been identified. The clinical course is characteristically one of rapidly progressive heart failure. Notably, only half of these fistulas were detected by transthoracic echocardiography, whereas all were identified by transesophageal echocardiography when utilized. Once the diagnosis is made, prompt surgical repair is required to avert the high mortality from rapidly developing refractory congestive heart failure.




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  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543