Traumatic fistula between the descending thoracic aorta and the left main pulmonary artery.

A patient sustained a low-velocity gunshot wound to the left chest which resulted in a clinically silent traumatic fistula between the descending thoracic aorta and the left main pulmonary artery. The bullet remained in the aorta and embolized to the left popliteal artery, from which it was removed 2 days after thoracotomy. Lateral repair of the aorta and pulmonary artery was performed as well as reinforcement of the posterior aortic wall which was weakened by the bullet as it ricocheted within the aorta. This appears to be the first reported case of a traumatic aorta to pulmonary artery fistula involving the descending thoracic aorta.