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Case Reports in Cardiology
Volume 2015, Article ID 473246, 4 pages
Case Report

Aortico-Left Atrial Fistula: A Rare Complication of Bioprosthetic Aortic Valve Endocarditis Secondary to Enterococcus faecalis

1Department of Medicine, Monmouth Medical Center, Long Branch, NJ 07740, USA
2Department of Cardiology, Robert Wood Johnson University Hospital, New Brunswick, NJ 08901, USA
3Department of Cardiology, Newark Beth Israel Medical Center, Newark, NJ 07712, USA

Received 15 May 2015; Accepted 9 June 2015

Academic Editor: Gerard Devlin

Copyright © 2015 Abhinav Agrawal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Paravalvular aortic root abscess with intracardiac fistula formation is an exceedingly rare complication of infective endocarditis. This condition is even more rarely encountered in patients with bioprosthetic valve endocarditis. We report an unusual case of a 68-year-old Bosnian female with a bioprosthetic aortic valve, who developed an extensive aortic root abscess, complicated by an aortico-left atrial intracardiac fistula. This case illustrates that a high index of suspicion, prompt diagnosis by echocardiography, proper antibiotic therapy, and early surgical intervention are crucial to improving treatment outcomes for this rare condition.