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Research Article | DOI: https://doi.org/10.31579/2835-8325/124

Aorto-pulmonary Fistula

  • Ramachandran Muthiah *

Morning star hospital, Enayam Thoppu, Kanyakumari District, India

*Corresponding Author: Ramachandran Muthiah, President of all Nations Morning Star Hospital, Enayam Thoppu, Kanykumari District, India

Citation: Ramachandran Muthiah, (2024), Aorto-pulmonary Fistula, Journal of Thoracic Disease and Cardiothoracic Surgery; 5(4): DOI: 10.31579/2835-8325/124

Copyright: © 2024 Ramachandran Muthiah, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Received: 24 October 2024 | Accepted: 05 November 2024 | Published: 13 November 2024

Keywords: dilated aortic root; intimal flap; aortic insufficiency; aortic rupture; aortopulmonary fistula

Abstract

Aim: Topresent a rare occurrence of aortopulmonary fistula due to rupture of proximal aortic dissection in 48-year-old women. Introduction: Aortic dissection is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. Case Report: 48-year-old women presented with vague anterior chest discomfort, high blood pressure, systolic-diastolic murmur in the left sternal border with ECG changes of myocardial ischemia. Echocardiography revealed a dilated aortic root with intimal flaps, a leak into the pulmonary artery and regionalhypokinesis with contractile dysfunction suggesting a proximal aortic dissection with rupture into the main pulmonary artery. Discussion: The etiology of aortic dissection include mostly hypertension in 80 % of cases and aortopathies such as connective tissue disorders, inflammatory and sometimes idiopathic. Aortic wall stress is a major trigger of intimal tear and two-dimensional transthoracic echocardiography is an excellent, initial diagnostic gold standard to detect the dissecting flaps, especially in proximal aortic dissection. Conclusion: Blood pressure control is the mainstay of treatment and urgent surgery is indicated in proximal aortic dissection since there is higher chance of rupture with an increase in mortality.

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