Japanese Journal of Cardiovascular Surgery Vol44,No1

A Case of Left Ventricular-Right Atrial Communication Resulting from Infective Endocarditis

Daisuke Mori Dai Araki Yutaka Makino and Tatsuya Murakami

(Department of Cardiovascular Surgery, Oji General Hospital, Tomakomai, Japan)

We report a case of surgical repair of acquired left ventricular-right atrial communication resulting from infective endocarditis. A 70-year-old man with aortic regurgitation due to infective endocarditis was referred to our hospital because of congestive heart failure. Preoperative transthoracic echocardiography showed severe aortic regurgitation and left ventricular-right atrial shunt flow. He underwent surgery following intensive antibiotic therapy. The fistula was located at the atrioventricular membranous septum. The communication site from the left ventricular view it was below the commissure between the left and the non-coronary cusps, and from the right atrial view it was above the tricuspid annulus of the septal leaflet. The fistula was closed with autologous pericardial patch from the aortotomy and a mattress suture from the right atriotomy. Aortic valve replacement was performed simultaneously. The postoperative course was uneventful. He was in sinus rhythm all the time. It is important to discuss surgical procedure preoperatively with precise echocardiographic examination. 


Jpn. J. Cardiovasc. Surg. 44:1-7(2015)

Keywords:left ventricular-right atrial communication;infective endocarditis;patch closure

Jpn. J. Cardiovasc. Surg. 44:50-52(2015)