Unusual complication of aortic root reconstruction with sparing of the aortic valve: left ventricular outflow tract to right atrial fistula.

The technique of aortic root reconstruction with sparing of the native aortic valve has been adopted in patients with dilatation or dissection of the aortic root and normal, functional aortic valve leaflets. We report two patients who developed an unusual complication of this surgical procedure: a left ventricular outflow tract to right atrial fistula. The clinical presentation of these patients, the steps leading to the diagnosis of the fistula, and the mechanism of fistula development are outlined. Specific emphasis is placed on echocardiographic diagnosis and differential diagnosis of a left ventricular outflow tract to right atrial fistula.