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J Thorac Cardiovasc Surg 2003;126:598-600
© 2003 The American Association for Thoracic Surgery

Brief communication

Severe pulmonary stenosis and aortopulmonary fistula caused by a dissecting aneurysm in the ascending aorta

^a Department of Cardiovascular Surgery, Saitama Medical School, Saitama, Japan
^b Department of Cardiology, Saitama Medical School, Saitama, Japan
^c Department of Cardiothoracic Surgery, University of Tokyo, Tokyo, Japan

Received for publication November 19, 2002; accepted for publication December 9, 2002.

^* Address for reprints: Kazuhito Imanaka, MD, Department of Cardiovascular Surgery, Saitama Medical School, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan
imanaka@saitama-med.ac.jp

The first 20% of the full text of this article appears below.

A 35-year-old man was referred to our hospital because of persistent fever lasting for 1 month, mild dyspnea, and continuous heart murmur. Oral and intravenous antibiotics had been administered at another hospital. The leukocyte count was 12,000/µL, and the serum C-reactive protein level was 3 mg/dL. The patient had never had severe pain in the chest or in the back, but he had a 1-year history of multiple systemic abscesses that spontaneously developed and healed. Several imaging studies revealed a dissecting aneurysm in the ascending aorta that compressed the pulmonary artery (PA), causing severe pulmonary stenosis (pressure gradient, 75 mm Hg on echocardiography), and that was accompanied by a fistula into the PA (Figure 1). Proximally, the aneurysm reached the level of the aortic valve annulus. A moderate amount of right pleural effusion and marked liver congestion were also noted. On that day, he was admitted to our hospital. However, severe PA stenosis precluded successful right-heart catheterization. Antibiotic therapy was discontinued, but blood culture failed to disclose causative organisms. The clinical condition of the patient remained almost stable for 5 days, but . . . [Full Text of this Article]

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				M. Mukadam, J. Barraclough, P. Riley, and R. Bonser Acquired aorto-pulmonary artery fistula following proximal aortic surgery Interact CardioVasc Thorac Surg, October 1, 2005; 4(5): 388 - 390. [Abstract] [Full Text] [PDF]