Esophageal-Left Atrial Fistula: Intraoperative Diagnosis and Management Minh-Tri Jean-Pierre Nguyen, MD, Sébastien Trop, MD, PhD, Constantine Soulellis,

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Esophageal-Left Atrial Fistula: Intraoperative Diagnosis and Management Minh-Tri Jean-Pierre Nguyen, MD, Sébastien Trop, MD, PhD, Constantine Soulellis, MD, Peter Szego, MD, FRCPC, Lorenzo E. Ferri, MD, FRCSC The Annals of Thoracic Surgery Volume 84, Issue 2, Pages 648-650 (August 2007) DOI: 10.1016/j.athoracsur.2007.02.091 Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Upper gastrointestinal double contrast barium study revealing a small traction diverticulum in the mid-lower esophagus (arrowhead). The Annals of Thoracic Surgery 2007 84, 648-650DOI: (10.1016/j.athoracsur.2007.02.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Upper endoscopy demonstrating a stenotic ulcerated lesion at the lower third of the esophagus representing the esophageal-left atrial fistula later confirmed intraoperatively (arrowhead). The Annals of Thoracic Surgery 2007 84, 648-650DOI: (10.1016/j.athoracsur.2007.02.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 After repair of the esophageal-left atrial fistula, the left atrium is being retracted to expose the 4-0 polypropylene pursestring suture used to exclude the weakened atrial wall. (LA = left atrium; LMB = left main bronchus; RLL = right lower lobe; RMB = right main bronchus; white arrow = pericardial edge; white arrowhead = 4-0 polypropylene pursestring suture excluding the weakened atrial wall.) The Annals of Thoracic Surgery 2007 84, 648-650DOI: (10.1016/j.athoracsur.2007.02.091) Copyright © 2007 The Society of Thoracic Surgeons Terms and Conditions