CTICasesAortopulmonary Fistula post Dissection Repair
Imaging findings
Delayed CT angiography in a patient with prior Type A dissection repair shows a large pseudoaneurysm arising from a graft leak in the aortic arch, with contrast extravasating directly into the right pulmonary artery (aortopulmonary fistula).
Key takeaways
Aortopulmonary fistula is a rare, late complication of thoracic aortic surgery or dissection repair. Chronic leaks at the graft anastomosis can form pseudoaneurysms that erode into the adjacent pulmonary artery. Delayed CT angiographic phases are essential to visualize contrast shunting.
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