Acquired post-infarct Gerbode defect complicated by infective endocarditis with giant right atrial vegetation

Raja, Yogesh; Jenkins, Nick; Chauhan, Anoop; Millner, Russell

doi:10.1016/j.ijcard.2006.04.073

Cited by 8 publications

(3 citation statements)

References 4 publications

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“…Fever (8 patients, 9.1%) was a more common symptom in the acquired group patients. Aortic wall abscesses were seen in 9 patients (10.2%) [ 33 , 39 , 40 , 53 , 55 , 58 , 78 , 87 , 104 ] and atrioventricular block in 12 (13.6%) (2 were with aortic wall abscess [ 39 , 61 ], 6 were third degree [ 39 , 61 , 82 , 89 , 99 , 102 ] and 6 were first degree [ 18 , 44 , 48 , 86 , 101 , 102 ]) of the acquired group patients but in none in the congenital patients. There was significant dominance of right atrium dilation, right ventricle dilation, tricuspid regurgitation and pulmonary artery hypertension ( Table I ).…”

Section: Resultsmentioning

confidence: 99%

Expert review Left ventricular to right atrial shunt (Gerbode defect): congenital versus acquired

Yuan¹

2014

pwki

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IntroductionCongenital left ventricular to right atrial (LV-RA) shunt (Gerbode defect) is rare, while acquired LV-RA shunt has been increasingly reported. As yet, systematically incorporated data of the LV-RA shunt have not been presented.AimTo present the clinical features, diagnostic challenge and management strategies of congenital and acquired LV-RA shunts.Material and methodsThe data source was based on a comprehensive literature retrieval of the LV-RA shunt in the period 1990–2013.ResultsIn comparison with the acquired Gerbode defect, the congenital Gerbode defect group of patients were younger and were associated more often with additional congenital disorders. Previous cardiac surgery and infective endocarditis were the two major aetiologies of the occurrence of the acquired shunts. Paravalvular abscess was associated in 10.2% and atrioventricular block in 13.6% of the acquired group patients. Transoesophageal echocardiography showed a higher diagnostic accuracy, lower missed diagnosis and lower inclusive diagnosis rates, in comparison to transthoracic echocardiography, but the misdiagnosis rates of the two modalities did not differ from each other. Four (4.5%) of the acquired group patients were complicated by atrioventricular block following surgical or interventional closure of the shunt. Eight (9.1%) patients died in the acquired group, but no patient died in the congenital group.ConclusionsThe diagnosis of an LV-RA shunt is quite challenging, especially in the context of coexisting abnormalities including an additional intracardiac shunt, tricuspid regurgitation, pulmonary artery hypertension and infective endocarditis, which have to be carefully differentiated from the shunt by further investigations. A better control of infective complications and careful manoeuvres during surgery may help to keep the LV-RA-sensitive septum intact.

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Section: Resultsmentioning

confidence: 99%

Expert review Left ventricular to right atrial shunt (Gerbode defect): congenital versus acquired

Yuan¹

2014

pwki

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“…Alphonso [ 12 ] 2003 Male/ 63 AV Culture negative TTE Surgery Survived 9. Raja [ 13 ] 2006 Male/47 RA Staphylococcus aureus TTE, TEE Surgery Survived(RF) 10. Fukui [ 14 ] 2007 Male/57 TV, AV, MV na TEE Surgery Survived 11.…”

Section: Commentmentioning

confidence: 99%

Acquired Gerbode defect following endocarditis of the tricuspid valve: a case report and literature review

Prifti

Ademaj

Baboci³

et al. 2015

J Cardiothorac Surg

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The Gerbode’s defect is a communication between the left ventricle and right atrium. It is usually congenital, but rarely is acquired, as a complication of endocarditis, myocardial infarction, trauma, or after previous cardiac surgery. The acquired Gerbode defect with involvement of the tricuspid valve acquired after bacterial endocarditis can be challenging to repair. We present a rare case of young woman, with endocarditis of the tricuspid valve and acquired Gerbode defect without previous cardiac surgery. She underwent successful surgical closure of the Gerbode defect and reconstruction of the septal leaflet of the tricuspid valve using a an autologous pericardial patch. A total of 20 other cases were reported with acquired Gerbode defect due to endocarditis in patients without previous cardiac surgery. Three other cases presented acquired Gerbode defect due to myocardial infarction and two due to chest trauma. Another series of 62 patients presented acquired Gerbode defect after previous cardiac surgery. Surgical treatment is always feasible with excellent outcome. However the percutanous transcatheter closure remains an excellent option especially in high risk patients.

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“…[1] These defects are usually congenital, as indicated by Gerbode [2]and they have also been reported after bacterial endocarditis [1] and after acute myocardial infarction. [3] Echocardiography is the most useful diagnostic method. [4][5][6] On June 2004, a 68-year-old Italian woman was referred to the clinic complaining of dyspnea, weakness and ankle edema.…”

Section: Case Reportmentioning

confidence: 99%

Echocardiographic diagnosis of syndrome of left ventricular-right atrial shunt (Gerbode defect)

Patanè

Marte

Bella

2008

International Journal of Cardiology

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Acquired post-infarct Gerbode defect complicated by infective endocarditis with giant right atrial vegetation

Cited by 8 publications

References 4 publications

Expert review Left ventricular to right atrial shunt (Gerbode defect): congenital versus acquired

Expert review Left ventricular to right atrial shunt (Gerbode defect): congenital versus acquired

Acquired Gerbode defect following endocarditis of the tricuspid valve: a case report and literature review

Echocardiographic diagnosis of syndrome of left ventricular-right atrial shunt (Gerbode defect)

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