Aorto-pulmonary fistula: a rare event in the evolution of a dissecting aneurysm of the thoracic aorta

The natural history of a thoracic aneurysm is usually towards thedissection or free rupture; rarely an aorto-pulmonary fistula cancomplicate this lesion. We present two cases of Aorto-pulmonary fistula asacute complication of an aneurysm of thoracic aorta; the etiopathology seemto be related to the same mechanism: a dissecting aneurysm of the ascendingaorta leading to a secondary fistulation in the main pulmonary artery. Inour two cases the diagnosis was suggested by clinical findings and byDoppler-echocardiography. Both patients were managed surgically withsuccess and both survived.