Yokoyama M, Yamada T, Nakahara H, Oshima N, Tanabe S, Irie Y
Department of Cardiovascular Surgery, Dokkyo University School of Medicine, Koshigaya Hospital, Saitama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Sep;38(9):1483-7.
A case of an acquired left ventricular-right atrial communication complicating Omnicarbon replacement of a severe calcified mitral valve in the area of the posteromedial commissure is reported. The intricate relationships of the membranous atrioventricular septum to the mitral valve and the tricuspid valve predispose to the creation of an iatrogenic left ventricular-right atrial fistula when aggressive debridement of extensive valvular calcification is performed. Emphasis is placed on the diagnosis, and immediate surgical repair is advocated as soon as this complication is discovered.