From the Department of Anesthesiology, Emory University School of Medicine, Grady Memorial Hospital, Atlanta, Georgia.
A A Pract. 2020 Jun;14(8):e01233. doi: 10.1213/XAA.0000000000001233.
Aortoatrial fistula formation is a rare complication of bacterial endocarditis. Fistulous tracts may form between the aorta and either atrium. Clinical presentation varies from an insignificant murmur to refractory congestive heart failure. Most clinically relevant fistula manifests with acute and severe symptoms. Transesophageal echocardiography (TEE) is more sensitive than transthoracic echocardiography (TTE) in diagnosing intracardiac shunts, and invaluable in guiding intraoperative surgical repair. Definitive therapy involves closure of the fistula either through an open surgical approach or percutaneously with an occluder device.
主动脉-房间隔瘘是细菌性心内膜炎的罕见并发症。瘘管可能在主动脉和任何一个心房之间形成。临床表现从无意义的杂音到难治性充血性心力衰竭不等。大多数有临床意义的瘘表现为急性和严重的症状。经食管超声心动图（TEE）比经胸超声心动图（TTE）更敏感，可诊断心内分流，并在指导术中手术修复方面具有不可估量的价值。明确的治疗方法包括通过开放手术或经皮使用封堵器来关闭瘘管。
