Aortopulmonary fistula

Background. Aortopulmonary fistula is an uncommon but usually fatal conditi on if not treated surgically. The most frequent cause is erosion of a false aneurysm of the descending thoracic aorta into the left lung. Methods. Review of charts of all patients who had had resection of a thorac ic aortic aneurysm at the MidAmerica Heart Institute (1971 to 1997) reveale d three cases in which the presentation was hemoptysis resulting from an ao rtopulmonary fistula. The clinical features and course of each patient are summarized in this report. Results. The three patients with hemoptysis due to an aortopulmonary fistul a had emergency surgical intervention with no major complication. Conclusions. Any patient who has an otherwise unexplained hemoptysis and a history of a previous thoracic aortic surgical procedure or is known to hav e a thoracic aortic aneurysm should have appropriate clinical evaluation to exclude the presence of an aortopulmonary fistula. If an aortopulmonary fi stula cannot be excluded, emergency operation should be done.