Post Bentall procedure with perigraft leak and Cabrol fistula


This case shows a patient who underwent repair of the aortic root and ascending aorta for Stanford A aortic dissection (Bentall procedure).  Intractable bleeding at the region of the aortic root was encountered during surgery which resulted to hematoma formation in the perigraft space.  The surgeon decided to create the Cabrol fistula to decompress the perigraft space.  The created fistula was expected to spontaneously close after surgery when the bleeding stops.  However, the bleeding persisted resulting to continuous flow of blood from the aorta into the perigraft space and eventually into the right atrium through the patent Cabrol fistula.  This left-to-right shunting of blood resulted to high-output cardiac failure.