Infective Endocarditis of the Aortic Valve Complicated by Aorta–To–Pulmonary Artery Fistula

摘要

class="kwd-title">Keywords: Endocarditis, Aortopulmonary fistula, Echocardiography class="head no_bottom_margin" id="sec1title">IntroductionInfective endocarditis (IE) is a common entity in clinical practice, and echocardiography plays a key role in diagnosis, prognostication, and surveillance. In addition to determining the presence of vegetations, echocardiography is crucial in assessment for structural complications caused by IE and in decision making for surgical intervention. Intractable heart failure, embolization, and signs of uncontrolled infection such as abscess, false aneurysm, and fistula formation are indications for urgent cardiac surgery. Although complications of uncontrolled infection are relatively uncommon, they can cause rapid clinical deterioration and increased morbidity. Additional hemodynamic data such as pulmonary artery pressure, cardiac output, and parameters of valve function obtained by echocardiography also assist in determining whether clinical deterioration in critically ill patients is due to complications from IE, with serial echocardiography aiding in the determination of prognosis and response to medical therapy. We present a case of IE with the rare complication of an ascending aorta–to–pulmonary artery fistula diagnosed by echocardiography and compare this with other causes of aortopulmonary connections.