Work

Aorto–Right Atrial Fistula Complicating Transseptal Puncture

Year: 2025

Type: article

Abstract: BACKGROUND: Aorto-right atrial (RA) fistula is a rare and complex pathological condition, most often occurring as an iatrogenic complication. CASE SUMMARY: We present a case of percutaneous closure of aorto-RA fistula, which resulted from an inadvertent transseptal puncture during atrial fibrillation ablation. Computed tomography with 3-dimensional reconstructions was used to identify the optimal fluoroscopic projection, clarify the anatomy of the fistula, and select the most appropriate closure device. The noncoronary cusp was isolated using the cusp overlap view to optimize device alignment and deployment. A Jugular venous approach in combination with a femoral arterial access allowed us to create an arteriovenous loop. A 6/4-mm Amplatzer Duct Occluder (Abbott) was successfully implanted. DISCUSSION: Multimodality imaging has a pivotal role to guide the interventional strategy. Technical skills and experience in structural practice are crucial to achieve a good result. TAKE-HOME MESSAGE: Percutaneous closure represents a feasible and effective treatment of aorto-RA fistula.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.106062

Authors: Francesco Giangiacomi, Eric Eeckhout, Xavier Galloo, Stijn Lochy

Institutions: Vrije Universiteit Brussel, University of Milan, Universitair Ziekenhuis Brussel

Language: English

Topic: Cardiac Arrhythmias and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850