A rare case of prosthetic aortic valve endocarditis complicated with multiple fistula to peri aortic structure

Multiple aorto-cardiac cavity communications is very rare but important complication of prosthetic aortic valve endocarditis. The case below illustrates multiple aorto-cardiac cavity fistula formation following prostethic aortic valve endocarditis presented with slowly progressive symptoms of heart failure. A brief review of surgical reconstruction and the existing literature are presented, including emphasis on pre and intra operative echocardiographic diagnosis and treatment.