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Aorta--right atrial communication. Report of an unusual case.

The Journal of Thoracic and Cardiovascular Surgery

abnormalities, Adult, Aorta, surgery, Aortic Aneurysm, complications, diagnosis, Aortography, Diagnosis, Differential, Heart Atria, Humans, Male, Vena Cava, Superior

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      An unusual aneurysmal aorta--right atrial communication was found in a 25-year-old man with a rounded mass in the right cardiophrenic angle. Differential diagnoses included ruptured aneurysm of the sinus of Valsalva, coronary arteriovenous fistula, rupture of a dissecting aneurysm of the ascending aorta into the right atrium, and pseudoaneurysm of the right coronary artery followed by formation of a fistula between the aneurysm and the right atrium. Closure of the communication was performed under cardiopulmonary bypass. Complete absence of the right superior vena cava with a large persistent left superior vena cava draining to the coronary sinus was an unexpected finding at operation. The origin of the communication is not known; possible anomalous coronary and noncoronary origins are considered.

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