{"database":"biostudies-literature","file_versions":[],"scores":null,"additional":{"omics_type":["Unknown"],"volume":["30(24)"],"submitter":["Mohmand B"],"pubmed_abstract":["Aorto-pulmonary fistulas, often resulting from prior aortic surgeries, can lead to severe cardiac complications and are traditionally managed surgically. This case involves a 62-year-old man with a history of aortic stenosis and multiple surgeries, who presented with decompensated heart failure due to a fistula from a dehiscent aortic tube graft to the pulmonary artery, causing severe right ventricular failure. Given the high surgical risk, a novel percutaneous approach using a modified \"Tootsie Roll technique\" was employed, involving the deployment of a VBX-covered stent and a ventricular septal defect Amplatzer occluder, which significantly improved hemodynamics and resolved cardiogenic shock. This case underscores the potential of catheter-based techniques as viable alternatives or complements to surgery for managing complex aorto-pulmonary fistulas, particularly in high-risk patients, and highlights the essential role of comprehensive imaging in guiding such interventions, despite the absence of specific guidelines in current American College of Cardiology/American Heart Association recommendations."],"journal":["JACC. Case reports"],"pagination":["104684"],"full_dataset_link":["https://www.ebi.ac.uk/biostudies/studies/S-EPMC12371374"],"repository":["biostudies-literature"],"pubmed_title":["Percutaneous Closure of Aortic-Pulmonary Artery Fistula in Cardiogenic Shock: The Modified Tootsie Roll Technique."],"pmcid":["PMC12371374"],"pubmed_authors":["Kargoli F","Gideon PA","Amabile O","Eng MH","Suppah M","Morris M","Mohmand B","Naqvi A"],"additional_accession":[]},"is_claimable":false,"name":"Percutaneous Closure of Aortic-Pulmonary Artery Fistula in Cardiogenic Shock: The Modified Tootsie Roll Technique.","description":"Aorto-pulmonary fistulas, often resulting from prior aortic surgeries, can lead to severe cardiac complications and are traditionally managed surgically. This case involves a 62-year-old man with a history of aortic stenosis and multiple surgeries, who presented with decompensated heart failure due to a fistula from a dehiscent aortic tube graft to the pulmonary artery, causing severe right ventricular failure. Given the high surgical risk, a novel percutaneous approach using a modified \"Tootsie Roll technique\" was employed, involving the deployment of a VBX-covered stent and a ventricular septal defect Amplatzer occluder, which significantly improved hemodynamics and resolved cardiogenic shock. This case underscores the potential of catheter-based techniques as viable alternatives or complements to surgery for managing complex aorto-pulmonary fistulas, particularly in high-risk patients, and highlights the essential role of comprehensive imaging in guiding such interventions, despite the absence of specific guidelines in current American College of Cardiology/American Heart Association recommendations.","dates":{"release":"2025-01-01T00:00:00Z","publication":"2025 Aug","modification":"2026-05-01T03:15:15.355Z","creation":"2026-05-01T03:05:45.574Z"},"accession":"S-EPMC12371374","cross_references":{"pubmed":["40846380"],"doi":["10.1016/j.jaccas.2025.104684"]}}