JACC. Case reports · 2025
Transcatheter Repair of Aortopulmonary Fistula With VSD Occluder After Surgical Aortic Valve Replacement for Aortic Valve Endocarditis.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Valand Hardik A, Smith Triston, Lasorda David
Аннотация
BACKGROUND: Infective endocarditis can lead to the rare and potentially fatal aortopulmonary fistula.
CASE SUMMARY: We report a 52-year-old man with methicillin-sensitive Staphylococcus aureus bacteremia and aortic valve endocarditis complicated by a left middle cerebral artery stroke. After emergent aortic sinus debridement and valve replacement, imaging revealed an aortopulmonary fistula. Left-to-right shunting was confirmed. As traditional surgical repair was unsuitable, a ventricular septal defect occluder was deployed via a transcatheter approach. Follow-ups confirmed a well-seated device, mild pulmonic regurgitation, and no symptoms.
DISCUSSION: Effectively managing aortopulmonary fistulas in patients with infective endocarditis is a multidisciplinary process combining advanced imaging techniques, hemodynamic assessment, and an innovative percutaneous approach.
TAKE-HOME MESSAGE: This case demonstrates that a minimally invasive transcatheter approach is viable for managing aortopulmonary fistula in high-risk patients after valve replacement.
CASE SUMMARY: We report a 52-year-old man with methicillin-sensitive Staphylococcus aureus bacteremia and aortic valve endocarditis complicated by a left middle cerebral artery stroke. After emergent aortic sinus debridement and valve replacement, imaging revealed an aortopulmonary fistula. Left-to-right shunting was confirmed. As traditional surgical repair was unsuitable, a ventricular septal defect occluder was deployed via a transcatheter approach. Follow-ups confirmed a well-seated device, mild pulmonic regurgitation, and no symptoms.
DISCUSSION: Effectively managing aortopulmonary fistulas in patients with infective endocarditis is a multidisciplinary process combining advanced imaging techniques, hemodynamic assessment, and an innovative percutaneous approach.
TAKE-HOME MESSAGE: This case demonstrates that a minimally invasive transcatheter approach is viable for managing aortopulmonary fistula in high-risk patients after valve replacement.