A 50 year old man with an LV-RA fistula secondary to Staph. Areus endocarditis
underwent surgical repair of the fistula with insertion of a pericardial
patch.A 50 year old man with an LV-RA fistula secondary to Staph. Areus endocarditis
underwent surgical repair of the fistula with insertion of a pericardial
patch.
Two weeks after the operation he underwent a TEE for persistence of severe dyspnea.
The pericardial patch had become distended with elevation of the left ventricle pressure (secondary to congestive heart failure) and a bi-directional shunt across an atrial septal defect. The patch created a "Mass like" effect which mimicked an abscess.
This was confirmed intraopertively when the patient had to return to the OR for repair of the atrial septal defect.
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