• Cardiovascular medicine
• Radiology

• Humans
• Female
• Sinus of Valsalva/diagnostic imaging
• Aortic Aneurysm/diagnostic imaging
• Aortic Aneurysm/surgery
• Heart Defects, Congenital
• Echocardiography
• Aortic Rupture/diagnosis

• Aorta right atrial tunnel
• Aorto-ventricular tunnel
• Congenital aorto-cardiac communications
• Coronary cameral fistula
• Rupture of congenital sinus of Valsalva aneurysm

• Aorto-right atrial tunnel
• Coronary vessel anomalie
• Endocarditis
• Multidetector computed tomography angiography
• Transcatheter closure
• Transoesophageal echocardiography

• computed tomography angiography
• congenital descending aorta-right atrial tunnel
• congenital heart defects
• transcatheter closure
• ventricular septal defect occluder

• Aorta, Thoracic
• Child, Preschool
• Computed Tomography Angiography
• Diagnosis, Differential
• Heart Atria
• Heart Defects, Congenital/diagnosis
• Heart Defects, Congenital/diagnostic imaging
• Heart Defects, Congenital/surgery
• Humans
• Male
• Septal Occluder Device
• Vascular Fistula/diagnosis
• Vascular Fistula/diagnostic imaging
• Vascular Fistula/surgery

• American College of Cardiology
• American Heart Association
• European Society of Cardiology
• aortic root abscess
• aortic root allograft
• aortomitral curtain
• bicuspid aortic valve
• cardiopulmonary bypass
• fistula
• heart failure
• infective endocarditis
• mitral valve
• multidisciplinary team
• pneumonia
• right ventricular outflow tract
• septic emboli
• transesophageal echocardiography
• transthoracic echocardiography
• vegetation
• ventricular septal defect

• angiographic/fluoroscopic
• congenital heart disease
• fistula-shunts
• imaging
• pediatrics

To delineate the features and current therapeutic option of congenital and acquired aortocameral fistulas (ACF) secondary to iatrogenic or infectious disorders.

From a PubMed search using the term "aortocameral fistula", 30 suitable papers for the current review were retrieved. Reviews, case series and case reports published in English were considered. Abstracts and reports from scientific meetings were not included. A total of 38 reviewed subjects were collected and analyzed. In addition, another case - an adult male who presented with ACF between commissures of the right and non-coronary sinuses and right atrium as a late complication of Staphylococcus aureus infective endocarditis of the AV - is added, the world literature is briefly reviewed.

A total of thirty-eight subjects producing 39 fistulas were reviewed, analyzed and stratified into either congenital (47%) or acquired (53%) according to their etiology. Of all subjects, 11% were asymptomatic and 89% were symptomatic with dyspnea (21 ×) as the most common presentation. Diagnosis was established by a multidiagnostic approach in 23 (60%), single method in 14 (37%) (echocardiography in 12 and catheterization in 2), and at autopsy in 2 (3%) of the subjects. Treatment options included percutaneous transcatheter closure in 12 (30%) with the deployment of the Amplatzer duct or septal occluder and Gianturco coil and surgical correction in 24 (63%).

Acquired ACF is an infrequent entity which may occur late after an episode of endocarditis of the native AV. The management of ACF is generally by surgical correction but non-surgical device intervention has recently been introduced as a safe alternative.

• Aortic-atrial shunt
• Aortic-atrial fistulas
• Infective endocarditis
• Late complication
• Surgical correction

Sinus of Valsalva-right atrial fistulas are abnormal connections between the aorta and the right atrium, and present challenging surgical conditions. An extremely rare etiology of aorto-right atrial fistula is infective endocarditis. This case report presents a 21 year old Caucasian female patient who had native aortic valve Staphylococcus aureus endocarditis complicated by sinus of Valsalva abscess perforation associated with an acute heart block, an aorto-right atrial fistula, severe heart failure, and cardiogenic shock. She underwent emergent aortic valve replacement and complex sinus of Valsalva fistula pericardial patch reconstruction and repair. This case report further explores the advantages and disadvantages of different valves for different patient populations, and evaluates the patient’s prosthesis mismatch and effective orifice area.

A fistula is an abnormal vascular connection leading to diversion of blood from a high resistance arterial circuit to low resistance venous circuit. Coronary artery fistulas are abnormal communications of the coronary artery with a chamber of the heart, or with any segment of systemic or pulmonary circulation, bypassing the myocardial capillaries. Other unusual fistulas include connection between aorta and the right atrium/superior vena cava, aorta and the inferior vena cava or between a coronary artery bypass graft and a cardiac vein. Abnormal connections also include origin of the coronary artery from the pulmonary artery. In this article, we review the imaging, particularly computed tomography and magnetic resonance imaging of unusual fistulas and connections involving the cardiovascular system, particularly the coronary arteries and the aorta.

• Coronary
• Artery
• Fistula

Coarctation of aorta and sinus of Valsalva aneurysm are frequently missed congenital cardiac defects that their diagnosis might be delayed. To our knowledge, coincidence of these cardiac defects is unusual and has not been reported in the literature before. Here, we present a patient with coarctation of aorta and ruptured noncoronary sinus of Valsalva aneurysm leading to aorto-right atrial fistula in the early postpartum period and our management of this unusual case.