A communication between the aorta and the heart may be either acquired or congenital in origin. The aortic opening usually arises from an aortic sinus of Valsalva and the cardiac end of the fistula usually enters the right ventricle; however, less commonly, the fistula may empty into the right atrium or left ventricle. According to the excellent review of Morgan Jones and Langley,1 the communication is acquired in approximately 75% of cases, and usually results from rupture of an aortic sinus aneurysm.
Congenital cardioaortic fistulae, on the other hand, are quite uncommon, but important because of the problems in differential diagnosis which they present. The purpose of this article is to describe a case report of this unusual anomaly, and to discuss its diagnosis and management.
The patient, a 20-year-old white woman, was discovered to have a heart murmur at birth. However, she had a normal growth