Repair of Aortic–Left Atrial Fistula Following the Transcatheter Closure of an Atrial Septal Defect

We describe the surgical treatment of an aortic–left atrial fistula that appeared 6 months after the placement of an Amplatzer septal occluder for closure of a large secundum atrial septal defect. Successful repair of the fistula was accomplished by a combined transatrial–transaortic approach similar to that used to repair the rupture of a sinus of Valsalva aneurysm.