Atrial-oesophageal fistula

Dr Yair Glick and Ryan Kelsch et al.

Atrio-oesophageal fistulas are rare pathological connections between the left atrium and the oesophagus

The presentation is non-specific. Patients may complain of fever, malaise, and/or dysphagia, or present with neurological symptoms 3

The chief cause of atrial-oesophageal fistulas is iatrogenic in the setting of cardiac ablation procedures, although, theoretically, many mediastinal pathology or procedure could potentially cause a fistula.

CT is the modality of choice and may reveal a communication between the left atrium and the oesophagus which can be evidenced by IV contrast present in the oesophagus.

Other possible features include:

The treatment is surgical, including resection and repair of the necrotic heart tissue and oesophageal resection of the fistulous area. Oesophageal stenting can be used as a temporizing measure. The mortality rate is high at ~60% (range 40-80%).

Share article

Article information

rID: 41801
Tag: cases, cases
Synonyms or Alternate Spellings:
  • Atrio-esophageal fistula
  • Atrioesophageal fistula
  • Atriooesophageal fistula
  • Atrio-oesophageal fistulation
  • Atrial-oesophageal fistula
  • Atrial-esophageal fistula
  • Atrio-oesophageal fistula

Support Radiopaedia and see fewer ads

Updating… Please wait.

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.