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Case Reports

Aorto-Atrial Fistula 10 Days After Dissection Repair in Giant Cell Arteritis

^a Department of Anesthesiology and Intensive Care, Hotel Dieu de France Hospital, Beirut, Lebanon
^b Department of Cardiac Surgery, Hotel Dieu de France Hospital, Beirut, Lebanon
^c Department of Internal Medicine, Hotel Dieu de France Hospital, Beirut, Lebanon

Accepted for publication April 25, 2008.

^_* Address correspondence to Dr Haddad, Department of Anesthesiology and Intensive Care, Hotel-Dieu de France Hospital, Saint Joseph University, Alfred Naccache St, PO Box 166830, Beirut, Lebanon (Email: fflhlb{at}yahoo.com).

Active aortitis caused by giant cell arteritis occurs more commonly than has been previously appreciated, and ascending aortic dissection may occur despite medical therapy, without a preexisting aneurysm or ectasia. We report a case of acute type A aortic dissection in a patient already treated for giant cell arteritis. The aortic root was left intact during the initial surgery, but was completely removed 10 days later after an early postoperative aorto-atrial fistula. Complete removal of the aortic root (Bentall procedure) has been advocated in these patients to prevent late additional aortic complications.