Aorta-atrial fistula, a rare complication of prosthetic valve endocarditis

A 51-year-old male with a history of a mechanical Carbomedicsaortic and mitral valve replacement in 2003 and several re-operationsbecause of endocarditis of the mitral valve in 2007 presentedwith heart failure 68 days after operation. Echocardiographyconfirmed the presence of a fistulous connection between theaorta and the left atrium. Because of the multiple surgicalinterventions and high operative risk, an initial conservativemedical treatment was initiated and the clinical course wasuneventful to this date.