Acquired left ventricular to left atrial fistula--not mitral regurgitation! Transcutaneous closure with amplatzer device

Acquired left ventricle (LV) to left atrial (LA) fistula is a very rare complication following aortic valve replacement (AVR). This can usually be surgically repaired but the risk of re-operation is high due to repeat sternotomy and also due to other comorbidities usually seen in this population. We report a case presenting with recurrent episodes of left ventricular failure 10 years following bioprosthetic aortic valve replacement and who was diagnosed to have a communication between the LV and the LA on transesophageal echocardiography (TEE). This was treated percutaneously with an Amplatzer duct occluder (ADO) device (AGA Medical Corp.) as she was considered to be a high surgical risk.