@entity292 with XXXX from penetrating @entity130 .

@entity1 @entity712 @entity548 @entity2293 @entity75 @entity16 @entity886 @entity292 @entity1344 @entity130
A @entity1 with a delayed aorto-right ventricular fistula and @entity886 after penetrating @entity130 is reported, and 17 similar additional cases from the literature reviewed. By examining the aortic root of adults with normal cardiac anatomy at autopsy, we defined the target area for these injuries as a 2 X 2 cm contact surface between the aorta above the right coronary cusp and the right ventricular outflow tract below the pulmonary valve. Five of the 18 @entity1 required emergency exploration due to @entity1344 . Life-threatening sequelae ( @entity548 and @entity2293 ) result from the external injury rather than the intracardiac component. @entity16 is most commonly manifested as the delayed recognition of a cardiac murmur and some degree of @entity712 , and when these appear one must suspect @entity130 . We recommend cardiac catheterization and elective repair, maintaining control of both ends of the @entity292 with bolstered suture. @entity886 can often be primarily repaired. @entity1 with combination aortic valve and @entity130 , more so than those with a single @entity75 , fail with nonoperative management. Of the 18 @entity1 , 17 underwent surgery. One of these died: the others did well during short-term followup (less than 1 year).
