Cardiocutaneous fistula
- aDivision of Cardiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA, bCardiac Surgeons Group, 100 Asylum Avenue, Hartford, CT 06105, USA, cHoffman Heart Institute, Saint Francis Hospital and Medical Center, 114 Woodland Street, Hartford, CT, USA
- Dr Danias. e-mail: pdanias{at}bidmc.harvard.edu
- Accepted 21 July 1998
Abstract
Infection of the Teflon pledgets on the heart suture line after left ventricular aneurysm repair, presenting late with a fistulous tract connecting the heart with the skin (cardiocutaneous fistula) is an uncommon but potentially serious condition. The case is reported of a 73 year old man who developed a cardiocutaneous fistula extending through the left hemidiaphragm and draining at the abdominal wall, which developed six years after left ventricular aneurysmectomy. Following radiographic evaluation, which established the diagnosis, the Teflon pledgets and fistulous tract were successfully surgically removed. Prompt diagnosis depends on a high index of suspicion. Eradication of infection requires excision of infected material, which must be planned on an individual basis.
