Clinical and Echocardiographic Outcomes After Percutaneous Closure of Congenital Aortoatrial Fistula.

BACKGROUND

Aortoatrial fistula is a rare vascular anomaly that can lead to right-sided volume overload, heart failure, and arrhythmias. Early recognition and appropriate management are crucial to prevent complications.

CASE SUMMARY: A 58-year-old man presented with progressive dyspnea, palpitations, and fatigue for the past 3 months. Examination showed raised jugular venous pressure and a continuous murmur. Echocardiography and angiography confirmed a congenital aorto-right atrial fistula arising from the noncoronary sinus. The defect was closed percutaneously using a vascular plug via an arteriovenous loop-assisted snare technique. At the 9-month follow-up, the patient remained asymptomatic, with complete closure of the fistula and normalization of ventricular function.

DISCUSSION: This case shows the value of multimodality imaging in identifying rare congenital anomalies such as aortoatrial fistulae. Early diagnosis and successful transcatheter closure demonstrate the efficacy of percutaneous therapy in alleviating symptoms and preventing complications.

TAKE-HOME MESSAGE: Congenital aortoatrial fistula may present in adults; multimodality imaging and transcatheter closure enable effective management.