Case report: Aorto-left atrial fistula—A rare complication of native aortic valve endocarditis

Sheema Saadia, Fateh Ali Tipoo Sultan, Sara Iqbal, Saulat Hasnain Fatimi, Aiysha Nasir

Research output: Contribution to journalArticlepeer-review


Background: Aorto-cavitary fistula is a rare complication of infective endocarditis. Multimodal imaging is commonly required to assess the severity and extent of infection because of the complex pathology of the valvular and paravalvular apparatus in endocarditis. Case presentation: We present an unusual case of a middle-aged man with recent history of meningoencephalitis who developed infective endocarditis complicated by ruptured abscess in inter-valvular fibrosa between aortic and mitral valve resulting in free communication or fistula formation between aorta and left atrium. Patient underwent double valve replacement (aortic and mitral) along with repair of the aorta. Conclusions: Our case highlights recognition of this rare clinical presentation of aorto-left atrial fistula in infective endocarditis and the diagnostic role of transesophageal echocardiography in good clinical outcome with aggressive and timely management.

Original languageEnglish
Article number58
JournalEgyptian Heart Journal
Issue number1
Publication statusPublished - Dec 2023


  • Aortic endocarditis
  • Dual valve replacement (DVR)
  • Surgical treatment
  • Transesophageal echocardiography
  • Valvular heart disease


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