Magnetic resonance image (MRI) of an acquired aorto-pulmonary fistula, associated with cerebral and paradoxical embolism.

Aorto-pulmonary fistula has been described in Marfan's syndrome, with severe degeneration of connective tissue, particularly severe at the aortic site. Rarely, the chronic evolution of this condition could determine the formation of a fistula between the aorta and the adjacent anatomic structures [Ann Thorac Surg 59 (1995) 1563; J Cardiovasc Surg 29 (1988) 403; Thorax 28 (1973) 521]. Here, we describe the first case of aorto-pulmonary fistula, with cerebral and paradoxical embolism, described with angio-nuclear magnetic resonance (MRI) of the heart.