Pneumococcal aortic valve endocarditis causing aortopulmonary artery fistula

We report a case of an aortic-pulmonary artery fistula secondary to acute b acterial endocarditis and aortic root abscess formation. The patient presen ted with generalized symptoms and an initial pneumococcal pneumonia, then d eveloped respiratory and cardiac failure necessitating ventilation and inot ropic agents. An echocardiogram showed a vegetation in the aortic valve, an abscess involving the aortic root, and suggested a fistula between the aor ta and main pulmonary artery, which was confirmed at emergent operation. De spite a complicated early postoperative course the patient has made a full recovery. (C) 2001 by The Society of Thoracic Surgeons.