# A rare case report of an acquired aortopulmonary artery fistula after Bentall procedure: multimodality imaging approach may be the key?

## TL;DR

A rare case of a life-threatening heart condition after surgery was successfully diagnosed and treated using advanced imaging techniques.

## Contribution

Highlights the importance of multimodality imaging in diagnosing aortopulmonary fistulas after cardiac surgery.

## Key findings

- A 67-year-old man developed an aortopulmonary fistula after a Bentall procedure.
- Echocardiography and CT angiography confirmed the diagnosis and guided successful surgical repair.
- Multimodal imaging is critical for timely detection and treatment of this rare condition.

## Abstract

The acquired communication between the aorta and the pulmonary artery is a rare and potentially life-threatening condition. Its diagnosis is challenging and may require a multimodality imaging approach.

A 67-year-old Caucasian man, admitted for acute respiratory failure unresponsive to medical therapy and non-invasive ventilation, was diagnosed with an aortopulmonary fistula (APF) complicating a pseudoaneurysm of the aortic root. This condition developed after Bentall cardiac surgery, which entailed the use of a straight Dacron aortic graft coupled with a mechanical prosthesis. A multimodal imaging approach, combining echocardiography and computed tomography angiography, was diagnostic and supported the development of a surgical treatment strategy. The patient underwent successful surgical closure of the APF and correction of the aortic pseudoaneurysm.

Aortopulmonary fistula can result in rapid clinical deterioration if left untreated. The combination of echocardiography and computed tomography angiography techniques allowed for the diagnosis and surgical correction of the APF.