Aorto-Atrial Fistulas - A Contemporary Review.

Aorto-Atrial Fistulas - A Contemporary Review.

Cardiol Rev. 2017 Oct 25;:

Authors: Fierro E, Sikachi RR, Agrawal A, Verma I, Ojrzanowski M, Sahni S

Abstract
Aorto-atrial fistulas are a relatively rare, but potentially life-threatening condition, where an anomalous connection forms between the aortic structures and the cardiac atria. Aorto-atrial fistulas are most often the result of an underlying condition concerning the cardiac structures. It may be congenital, secondary to conditions such as aortic dissection, infective endocarditis, or valve replacement, or iatrogenic in nature. Secondary causes incite local deterioration of cardiac wall integrity leading to formation of fistulous connections, while iatrogenic causes are more traumatic in nature. Signs and symptoms include those of volume overload and heart failure with patients often presenting with fever, regurgitative murmurs, cardiac chamber dilation, and pedal edema. The diagnosis of aorto-atrial fistulas requires a high degree of clinical suspicion necessitating imaging techniques such as echocardiography, computer tomography, and more invasive procedures. Management is dependent on underlying conditions, and include the use of antibiotics, percutaneous closure, and in many cases, open heart surgery. It is important for physicians to be aware of this pathological condition to aid in timely management and favorable outcomes. This review attempts to summarize the various causes and clinical presentations of aorto-atrial fistulas over the past decades.

PMID: 29077586 [PubMed - as supplied by publisher]

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