Case report
Left ventricular–right atrial fistula complicating redo mitral valve replacement

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Abstract

We describe the case of a 58-year-old female patient who underwent redo mitral valve replacement and remained in heart failure. The diagnosis of a left ventricular–right atrial fistula was made. The fistula was closed surgically with a patch of autologous pericardium. The patient improved immediately after the operation and has been asymptomatic since.

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Comment

The development of structural defects is a rare complication after mitral valve replacement. Most commonly paravalvular leakage is observed and its development is largely prosthesis independent 1, 3. If the careful suture technique is used the incidence of paravalvular leakage approaches zero in uninfected patients [1]. A calcified mitral ring has been shown to be a predisposing factor for paravalvular leakage [1] as well as a redo operation [4]. A left ventricular–coronary sinus fistula

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