Gerbode defect: A comprehensive review of its history, anatomy, embryology, pathophysiology, diagnosis, and treatment

Abstract

The purpose of this paper is to survey the literature on Gerbode defect and provide an overview of its history, anatomy, development, pathophysiology, diagnosis, and treatment options. The available literature on this topic, including case reports, was thoroughly reviewed. Gerbode defect is defined as abnormal shunting between the left ventricle and right atrium resulting from either a congenital defect or prior cardiac insults. The pathophysiology underlying the development of Gerbode defect is a disease process that injures the atrioventricular septum and leads to the abnormal shunting of blood. Although the most prevalent cause of Gerbode defect has historically been congenital, an increasing trend towards acquired cases has recently been reported owing to improved diagnostic capabilities and a greater number of invasive cardiac procedures. In conclusion, Gerbode defect is an increasingly recognized condition that warrants further study.

Transnasal humidified rapid insufflation ventilatory exchange during bronchoscopy in severe pulmonary hypertension due to Gerbode defect

“…The patient was a 28‐year‐old, 57‐kg, female with severe pulmonary hypertension secondary to Gerbode defect, a left to right shunt between the left ventricle and the right atrium . Although she recalled dyspnoea and fatigue as a child compared to her peers, she was not evaluated by a physician until age 18 years.…”

Role of Cardiac MRI in Complicated Cardiac Defects

“…The initial diagnostic examination of choice is transthoracic echocardiography, but color flow Doppler cardiac MRI can reveal further detailed anatomical and physiological information. Cardiac MRI can enhance the shunt anatomy, measure left and right heart volumes, and quantify shunt flow [5]. Treatment of a Gerbode defect is surgical closure.…”

Gerbode defect

“…Reportedly, endocarditis causes LV–RA shunt by reconnecting a congenital defect, widening a small but nonsignificant shunt, or perforating the septum. [45]…”

“…Physiologically, a shunt is formed from the LV to RA due to a large pressure gradient that exists between these cardiac chambers. [5] Patients with IE usually present with fever and septicemia that may mask a new shunt formation, and the diagnosis of VSDs may easily be missed. [5] The Gerbode defect should be distinguished from other conditions, such as ruptured sinus of Valsalva aneurysms or VSD with severe tricuspid regurgitation.…”

“…[5] Patients with IE usually present with fever and septicemia that may mask a new shunt formation, and the diagnosis of VSDs may easily be missed. [5] The Gerbode defect should be distinguished from other conditions, such as ruptured sinus of Valsalva aneurysms or VSD with severe tricuspid regurgitation. The diagnosis in our patient was based on the echocardiographic findings: (i) atypical jet direction, (ii) persistent shunt flow into diastole, (iii) lack of ventricular septal flattening, (iv) no RV hypertrophy, and (v) normal diastolic pulmonary artery pressure as estimated from the pulmonic regurgitant velocity, suggesting the Gerbode defect.…”