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  • Title: Aorto-right atrial fistula secondary to rupture of an occluded old saphenous venous graft to right coronary artery.
    Author: Balestrini CS, Saaibi JF, Ortiz SN.
    Journal: Catheter Cardiovasc Interv; 2014 Sep 01; 84(3):513-8. PubMed ID: 23404794.
    Abstract:
    We report a case of an acquired aorta-right atrial fistula, secondary to a ruptured proximal anastomosis of an old saphenous vein graft 12 years after a coronary artery bypass surgery, in a 57 year old patient with multiple cardiovascular risk factors. On admission, he presented with congestive heart failure and on examination a continuous murmur was detected on the right parasternal border. Catheterization showed a fistula from the proximal anastomosis of an occluded right coronary artery saphenous vein graft draining to the right atrium with a large left to right shunt. The fistula was successfully occluded by a percutaneous approach with a Life Tech duct occluder with complete resolution of heart failure. The patient was discharged one week afterwards. After a two-year follow-up, the fistula remained occluded.
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