[Aortic insufficiency associated with ventricular septal defect and a coronary-right ventricle fistula after bacterial endocarditis: surgical correction of 3 lesions].

The authors report a case of Staph-aureus endocarditis on preexisting aortic incompetence. Two complications were observed during the course of the infection: ventricular septal defect, rare but classical, and coronary-right ventricular fistula, a complication not previously described to the best of the author's knowledge. Before the onset of endocarditis a continuous murmur had not been detected clinically or by phonocardiography. This sign appeared while the patient was receiving effective antibiotic therapy. The diagnosis, suggested by the clinical signs in a patient in cardiac failure, was confirmed by catheterisation. This type of complication, already described in peripheral vessels, may be understood when the extent of the lesions at the right coronary cusp, near the septum and right coronary ostium, are appreciated. A good surgical result was obtained due to early operation of the three lesions.