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Ann Thorac Surg 2003;76:929-931
© 2003 The Society of Thoracic Surgeons

Case report

Aorto-right atrial fistula

Ahmed F. Elwatidy, MD, FRCSa*, Ahmed N. Galal, MDa, David Rhydderch, FRCAa, Abdullah K. Ashmeg, FRCSa

a King Fahd Armed Forces Hospital, Cardiac Services Department, Jeddah, Saudi Arabia

Accepted for publication February 14, 2003.

* Address reprint requests to Dr Elwatidy, King Fahd Armed Forces Hospital, P.O. Box 9862, Jeddah 21159, Saudi Arabia
e-mail: afelwatidy{at}hotmail.com

We report a child in whom a fistula connected the descending thoracic aorta to the right atrium. This is a previously unreported cardiac malformation. The patient was initially misdiagnosed as having a patent ductus arteriosus (PDA). On clinical examination and auscultation, the problem was different from PDA in that the continuous machinery murmur was better heard on the right parasternal area and posteriorly on the left. Surgical ligation of the fistula through a left thoracotomy abolished the murmur.






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