Surgical management of endocarditis-induced aorto-atrial and aorto-ventricular fistula: a new technique.

Early onset aortic prosthetic valve endocarditis with annular extension of the infectious process remains a highly lethal disease. Destruction of the annular tissue requires complex techniques for repair. The most challenging situation is associated with destruction and fistula formation at the left fibrous trigone. We report a technique using the anterior mitral leaflet to repair an aorto-atrial and aorto-ventricular fistula. This technique places autologous tissue from the anterior leaflet of the mitral valve against the infected area, and may decrease the risk of reinfection.