Cardioaortic Fistula

Rupture of a sinus of Valsalva aneurysm into the right ventricle produces a dramatic clinical syndrome characterized by a rapid and relentlessly unfavorable course. Early diagnosis is essential for surgical repair before an irreversible stage is reached. Cardiac catheterization and retrograde aortography confirmed the diagnosis in the case reported. With the aid of temporary circulatory occlusion, the fistula was demonstrated by contrast material injected via an aortic catheter. Although the fistula and the accompanying ventricular septal defect were closed at open-heart surgery, the markedly enlarged heart could not resume its function.