{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:13:17Z","timestamp":1785409997300,"version":"3.56.0"},"reference-count":15,"publisher":"Radcliffe Medical Media Ltd","license":[{"start":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T00:00:00Z","timestamp":1771977600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/legalcode"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["US Cardiol"],"abstract":"<jats:p>Aortic pseudoaneurysms pose a higher risk of rupture due to elevated wall shear stress. Rupture into cardiac chambers is exceedingly rare, with no prior reported cases of an aortic pseudoaneurysm rupturing into the right ventricle. A 57-year-old man with a history of prior surgical ventricular septal defect repair, hypertension, and polysubstance use presented after being found unconscious and reported chest pain. Initial imaging revealed a large ascending aortic pseudoaneurysm (6.6 \u00d7 6.1 \u00d7 5.5 cm). While under conservative management with antihypertensive therapy, the patient developed cardiogenic shock and was found to have a new aorto-right ventricular fistula on echocardiography. Emergent surgical repair was conducted with patch repair of the fistula, ascending aorta replacement with a 34 mm graft, and placement of a right ventricular assist device for right ventricular failure. Prior cardiac surgery and poorly controlled hypertension likely contributed to pseudoaneurysm formation and subsequent rupture. The development of an aorto-right ventricular fistula introduced significant hemodynamic instability, necessitating high-risk surgical intervention. Multidisciplinary care is crucial for such rare and challenging presentations.<\/jats:p>","DOI":"10.15420\/usc.2025.07","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:27:33Z","timestamp":1771853253000},"source":"Crossref","is-referenced-by-count":0,"title":["Rupture of a Large Aortic Pseudoaneurysm into the Right Ventricle with Formation of Aorto-right Ventricular Fistula"],"prefix":"10.15420","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0738-998X","authenticated-orcid":false,"given":"Neel N","family":"Patel","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0011qv509","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Tennessee Health Science Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"Andrew O","family":"Zurick","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/0011qv509","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Tennessee Health Science Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6096","published-online":{"date-parts":[[2026,2,25]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Lavall D, Sch\u00e4fers HJ, B\u00f6hm M, Laufs U. Aneurysms of the ascending aorta. Dtsch Arztebl Int 2012;109:227\u201333. https:\/\/doi.org\/10.3238\/arztebl.2012.0227; PMID:\u00a022532815.","DOI":"10.3238\/arztebl.2012.0227"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Shang EK, Nathan DP, Boonn WW, et al. A modern experience with saccular aortic aneurysms. J Vasc Surg 2013;57:84\u20138. https:\/\/doi.org\/10.1016\/j.jvs.2012.07.002; PMID:\u00a023127980.","DOI":"10.1016\/j.jvs.2012.07.002"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Brown PM, Zelt DT, Sobolev B. The risk of rupture in untreated aneurysms: the impact of size, gender, and expansion rate. J Vasc Surg 2003;37:280\u20134. https:\/\/doi.org\/10.1067\/mva.2003.119; PMID:\u00a012563196.","DOI":"10.1067\/mva.2003.119"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Walpot J, Klazen C, Hokken R, et al. Aorto-right ventricular fistula as an occasional finding. Eur J Echocardiogr 2005;6:65\u20136. https:\/\/doi.org\/10.1016\/j.euje.2004.08.009; PMID:\u00a015664555.","DOI":"10.1016\/j.euje.2004.08.009"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"De Viti D, Santoro F, Raimondo P, et al. Congenital aorto-right ventricular fistula associated with pulmonary hypertension in an old female patient. J Cardiovasc Echogr 2018;28:141\u20132. https:\/\/doi.org\/10.4103\/jcecho.jcecho_58_17; PMID:\u00a029911015.","DOI":"10.4103\/jcecho.jcecho_58_17"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Konda MK, Kalavakunta JK, Pratt JW, et al. Aorto-right ventricular fistula following percutaneous transcatheter aortic valve replacement: case report and literature review. Heart Views 2017;18:133\u20136. https:\/\/doi.org\/10.4103\/HEARTVIEWS.HEARTVIEWS_115_16; PMID:\u00a029326776.","DOI":"10.4103\/HEARTVIEWS.HEARTVIEWS_115_16"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Vainrib AF, Ibrahim H, Hisamoto K, et al. Aorto-right ventricular fistula post-transcatheter aortic valve replacement: multimodality imaging of successful percutaneous closure. CASE (Phila) 2017;1:70\u20134. https:\/\/doi.org\/10.1016\/j.case.2017.02.002; PMID:\u00a030062248.","DOI":"10.1016\/j.case.2017.02.002"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Ghuran A, Nolan J. The cardiac complications of recreational drug use. West J Med 2000;173:412\u20135. https:\/\/doi.org\/10.1136\/ewjm.173.6.412; PMID:\u00a011112762.","DOI":"10.1136\/ewjm.173.6.412"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Gagnon LR, Sadasivan C, Perera K, Oudit GY. Cardiac complications of common drugs of abuse: pharmacology, toxicology, and management. Can J Cardiol 2022;38:1331\u201341. https:\/\/doi.org\/10.1016\/j.cjca.2021.10.008; PMID:\u00a034737034.","DOI":"10.1016\/j.cjca.2021.10.008"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Fritz AV, Boles KS, Martin AK. Echocardiographic evaluation of aorta to right atrial fistula secondary to ruptured sinus of valsalva aneurysm. Ann Card Anaesth 2018;21:313\u20134. https:\/\/doi.org\/10.4103\/aca.ACA_229_17; PMID:\u00a030052225.","DOI":"10.4103\/aca.ACA_229_17"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Ananthasubramaniam K. Clinical and echocardiographic features of aorto-atrial fistulas. Cardiovasc Ultrasound 2005;3:1. https:\/\/doi.org\/10.1186\/1476-7120-3-1; PMID:\u00a015655075.","DOI":"10.1186\/1476-7120-3-1"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Preventza O, Garcia A, Cooley DA, et al. Total aortic arch replacement: a comparative study of zone 0 hybrid arch exclusion versus traditional open repair. J Thorac Cardiovasc Surg 2015;150:1591\u20138; discussion 1598. https:\/\/doi.org\/10.1016\/j.jtcvs.2015.08.117; PMID:\u00a026573355.","DOI":"10.1016\/j.jtcvs.2015.08.117"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Chia R, Kalutota C, Cao K, et al. Management of aorto-right ventricular fistulas after TAVR. JACC Case Rep 2024;29:102655. https:\/\/doi.org\/10.1016\/j.jaccas.2024.102655; PMID:\u00a039619019.","DOI":"10.1016\/j.jaccas.2024.102655"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Samuels LE, Kaufman MS, Rodriguez-Vega J, et al. Diagnosis and management of traumatic aorto-right ventricular fistulas. Ann Thorac Surg 1998;65:288\u201392. https:\/\/doi.org\/10.1016\/s0003-4975(97)01084-9; PMID:\u00a09456147.","DOI":"10.1016\/S0003-4975(97)01084-9"},{"key":"ref14","doi-asserted-by":"crossref","unstructured":"Alabbady AM, Sattur S, Bauch TD, Harjai KJ. Aorto-right ventricular fistula and paravalvular leak after transcatheter aortic valve implantation. JACC Case Rep 2019;1:859\u201364. https:\/\/doi.org\/10.1016\/j.jaccas.2019.11.025; PMID:\u00a034316946.","DOI":"10.1016\/j.jaccas.2019.11.025"}],"container-title":["US Cardiology Review"],"original-title":[],"link":[{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2025.07","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T13:27:35Z","timestamp":1771853255000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.uscjournal.com\/articleindex\/usc.2025.07"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,25]]},"references-count":15,"URL":"https:\/\/doi.org\/10.15420\/usc.2025.07","relation":{},"ISSN":["1758-3896","1758-390X"],"issn-type":[{"value":"1758-3896","type":"print"},{"value":"1758-390X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,25]]},"article-number":"e02"}}