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Coronary interventions

Interventional treatment of an aortopulmonary window due to a ruptured suture of an aortic prosthesis

EuroIntervention 2015;11:956. DOI: 10.4244/EIJV11I8A192

Department of Cardiology, West-German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany
An 83-year-old morbid woman presented with severe dyspnoea (New York Heart Association [NYHA] Class IV) and a history of recurrent pulmonary oedema. Due to an acute type A aortic dissection, she had previously undergone aortic surgery (January 2009), which included the implantation of an ascending aortic prosthesis.

On admission, transthoracic echocardiography revealed severe pulmonary hypertension with an estimated systolic pulmonary pressure of 70-75 mmHg and severe tricuspid regurgitation. Using 3D transoesophageal echocardiography (Figure 1A, Moving image 1-3) and computed tomography (Figure 1B), a rupture of the aortic prosthesis with a fistula from the paraprosthetic lumen to the right pulmonary artery (...

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