Abstract

Background: An aorto-cameral fistula (ACF) is a rare and complex cardiovascular condition involving an abnormal connection between the aorta and one of the heart chambers. It can be either congenital or acquired. While the majority of cases (73.5%) are treated with open surgery, percutaneous interventions (a less invasive, catheter-based procedure) are used in about 10% of patients. Three cases were reported where ACFs were closed using the percutaneous method. This less invasive approach is becoming more popular because it avoids many risks associated with surgery, making it a more desirable treatment option. Cases: This report presents three unusual cases of aorto-cameral fistula (ACF) in two middle-aged women and one elderly male, all of whom experienced chest pain, palpitations, and progressive effort breathing. Two cases resulted from a ruptured sinus of Valsalva, and the third was idiopathic. In two instances, the abnormal connection was between the aortic sinus and the right atrium, while in the other, it was between the aortic sinus and the right ventricular outflow tract. Due to the lack of extensive clinical trials on ACF, treatment decisions are based on expert consensus. All three cases were successfully treated with percutaneous device closure. Conclusion: These cases emphasize the importance of recognizing the rare presentation of aorto-cameral fistula (ACF) and demonstrate the effectiveness of aggressive, noninvasive treatment through percutaneous closure. This approach resulted in positive clinical outcomes, avoiding the need for more invasive surgical correction.