2018 Volume 27 Issue 1 Pages 33-37
The 48 year-old-man who was urgently hospitalized with sudden chest pain, fever and dyspnea. According to laboratory findings, medical history and transthoracic echocardiography, we diagnosed acute heart failure due to Aorto–atrial fistula because of infectious endocarditis. His trachea was intubated at the emergency room, because respiratory failure and hemodynamic status was unstable. We transferred the patient to an operating room to perform emergency surgery. Saccular ascending aortic aneurysm pressed right atrium and superior vena cava.Under cardiopulmonary bypass, we made an incision in an aneurysm and detected a pseudo aneurysm from the posterior wall ruptured into left atrium. We performed m-Bentall’s operation, after left atrial fistula was closed direct suture. The patient was alive and free of disease 36 months after surgery. Because of our lack of experience, we were not able to definitively diagnose a syphilitic ascending aortic aneurysm ruptured into left atrium until confirmed postoperative pathological diagnosis. There have been only two cases reported, and one of whom underwent operation. We report this case including diagnosis, symptom and treatment, with bibliographical consideration.
