Thorac Cardiovasc Surg 2011; 59(4): 250-252
DOI: 10.1055/s-0030-1250647
Case Reports/Cardiac

© Georg Thieme Verlag KG Stuttgart · New York

Surgical Treatment of an Aorto-Right Atrial Fistula as a Complication of Tricuspid Valve Repair

P. R. Menon1 , T. Doenst2 , J. Ender1 , F. W. Mohr3 , D. Mathioudakis1
  • 1Department of Cardiac Anesthesiology, University of Leipzig Heart Center, Leipzig, Germany
  • 2Department of Cardiothoracic Surgery, Friedrich Schiller University of Jena, Jena, Germany
  • 3Department of Cardiac Surgery, University of Leipzig Heart Center, Leipzig, Germany
Further Information

Publication History

received October 5, 2010

Publication Date:
15 March 2011 (online)


We report a case in which implantation of a rigid tricuspid annuloplasty ring resulted in an aorto-atrial fistula. In addition the patient had a series of complications which had occurred in the perioperative management of the initial operation, characterized by reoperation for mitral and tricuspidal ring dehiscence, and two reopenings for bleeding as well as postoperative sepsis. The attempt to close the fistula on the arrested heart failed. On presentation to our hospital the patient was in decompensated heart failure (NYHA class IV, ascites and pulmonary edema). Our surgical approach (fifth resternotomy) consisted of mitral valve replacement under cardioplegic arrest and re-tricuspid valve repair and closure of the AV fistula on the beating heart. Postoperatively, the patient was extubated on postoperative day one and discharged on postoperative day 41 in NYHA class II. Conclusion: Performing a right heart procedure on the beating heart allowed proper identification of the fistula and easy closure.


Prof. Torsten Doenst, MD

Department of Cardiothoracic Surgery
Friedrich Schiller University of Jena

Erlanger Allee 101

07747 Jena


Phone: +49 3 64 19 32 29 01

Fax: +49 3 64 19 32 29 02

Email: [email protected]