SURGICAL-TREATMENT OF A FISTULA BETWEEN THE RIGHT PULMONARY-ARTERY AND THE LEFT ATRIUM - PRESENTATION OF 2 CASES AND REVIEW OF LITERATURE

Objective: A direct communication between the pulmonary artery and the left atrium is a rare anomaly. On the basis of two cases of our own a nd a literature review of 49 cases. we focus on clinical presentation? anatomy. diagnosis, and the role of surgery. Methods: Two cases of a fistula between the right pulmonary artery and the left atrium are des cribed in a girl of 4 years and a boy of 15 years. Both presented with unexplained cyanosis. Diagnosis was made on echocardiography and angi ography. The fistula was ligated using extracorporeal circulation in t he first case and not in the second case. Results: The surgical result s were successful with resolution of the cyanosis. Conclusions: In new borns. urgent surgery may be necessary. In other patients, early elect ive surgical correction should be performed to prevent complications, especially systemic and cerebral emboli. cerebral abscesses, and ruptu re of aneurysmal fistulas. Complete cure can be achieved by ligation a nd possible division or by intracardiac repair. (C) 1997 Elsevier Scie nce B.V.