AUTHOR=Ziebell Nágila Simon , Perin Luiz Felipe , Rossi Filho Raul , Horowitz Estela Suzana Kleiman , Vieira José Luiz da Costa , Caovilla Fábio Vieira , Sarmento Leite Rogerio Eduardo Gomes 

TITLE=Aortopulmonary fistula following mitral valve replacement: a case report

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2025.1664133

DOI=10.3389/fcvm.2025.1664133

ISSN=2297-055X

ABSTRACT=Acquired aortopulmonary fistula is a rare condition that may cause heart failure symptoms secondary to high-output pulmonary overload. We report an unusual case of an aortopulmonary fistula secondary to an aortic injury sustained during mitral valve replacement, which was identified during follow-up because of recurrent heart failure symptoms and repeated hospital admissions. Multimodality imaging enabled precise characterization of the fistula. After a Heart Team discussion, percutaneous closure was selected as the preferred treatment strategy. Based on the assessment of the trajectory and morphology of the fistula, a patent ductus arteriosus (PDA) occluder was chosen. Although the ostium of the fistula was challenging to identify, successful closure was achieved using the PDA occluder.