Real-time three-dimensional transesophageal echocardiography of the Gerbode defect

Millán, Raúl; Pericàs, Pere; Forteza, J.; Rodríguez, Antonio Fernández; Pascual, Marcos; Vidal, Laura; Bonnín, Oriol; Bethencourt, Armando

doi:10.1016/j.ijcard.2011.09.048

Cited by 5 publications

(4 citation statements)

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“…Equal results were obtained between cardiac catheterisation and TTE [ 8 ] and between TTE and TEE [ 110 ] in one patient, each. Additionally, identical results of Qp/Qs were obtained by non-invasive (MRI and TTE) and invasive measurements (cardiac catheterisation) in 2 patients [ 25 , 26 ]. Quantitative analysis did not reveal any intergroup differences in VSD size, Qp/Qs , peak velocity, pressure gradient across the VSD and pulmonary artery pressure.…”

Section: Resultsmentioning

confidence: 64%

“…By echocardiography, the associated cardiac anomalies can be easily disclosed, whereas the VSD is sometimes be overlooked due to the dominance of the defect caused by the prosthesis in the aortic position [ 3 ]. Moreover, LV-RA shunts may display in several distinct anatomies on echocardiography, such as elongated sail-like [ 28 ], flap-like [ 38 ], a fistula form [ 85 ], a cystic thin walled structure [ 26 ], or a windsock-type tunnel appearance [ 8 , 94 ], which make diagnosis difficult. To further define shunt anatomy and to quantify the shunt ratio, cardiac catheterisation and MRI are often advocated [ 74 ].…”

Section: Discussionmentioning

confidence: 99%

“…The retrieval resulted in a collection of 111 articles [ 2 – 113 ], which included 77 (59.3%) case reports [ 3 , 5 – 7 , 9 , 12 – 14 , 16 , 17 , 19 – 23 , 25 – 28 , 30 , 33 , 35 – 37 , 39 , 42 , 44 – 54 , 57 , 59 – 61 , 63 – 67 , 71 , 76 – 80 , 82 , 84 – 89 , 92 – 97 , 99 – 107 , 110 – 112 ] (including 8 (7.4%) case reports in the name of “letter to the editor” [ 5 , 25 , 26 , 30 , 79 , 84 , 92 , 111 ]), 17 (17.6%) medical images [ 2 , 10 , 11 , 15 , 22 , 32 , 40 , 41 , 43 , 58 , 69 , 70 , 72 , 74 , 98 , 108 , 109 ], 5 (4.6%) case series [ 8 , 18 , 34 , 38 ...…”

Section: Methodsmentioning

confidence: 99%

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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: 64%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Yuan¹

2014

pwki

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“…Two types of LVRAS has been described, depending on whether the defect was superior or inferior to the tricuspid valve (Ozdogan and Cinar, 2012;Ying and Chen, 2013). The infravalvular type is more common, and usually congenital (Millan et al, 2012), with an indirect shunt between the LV and RA. By contrast, the supravalvular type is usually acquired, with the defect located in the atrioventricular portion of the membranous septum, leading to a direct shunt between LV and RA.…”

Section: Higher Incidence Of Atrial Fibrillation In Left Ventricular-mentioning

confidence: 99%

Higher Incidence of Atrial Fibrillation in Left Ventricular-to-Right Atrial Shunt Patients

et al. 2020

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Background: The possible association between atrial fibrillation (AF) and left ventricular-to-right atrial shunt (LVRAS) has never been reported yet. The present study investigated the incidence of AF in LVRAS.Methods: This was a retrospective study of consecutive patients undergoing echocardiography at a single tertiary center. Clinical data, laboratory results and echocardiography parameters such as right atrial area (RAA), right ventricular end diastolic diameter (RVDD) and left atrial diameter (LAD) were compared between LVRAS group and non-LVRAS patients, and between AF and non-AF patients. Propensity score matching was performed to decrease the effect of confounders. Logistic regression analysis and mediation analysis were used to estimate the relationship between LVRAS and AF.Results: A total of 3,436 patients were included, and the incidence of LVRAS was 1.16% (n = 40). The LVRAS group had significantly larger RAA, RVDD and LAD compared with non-LVRAS group. Those who suffered from AF showed larger RAA, RVDD and LAD compared with those who maintained sinus rhythm. Multivariable logistic regression showed that gender (OR: 0.608), age (OR: 1.048), LAD (OR: 1.111), mean pulmonary artery blood pressure (mPAP, OR: 1.023), TR (OR: 2.309) and LVRAS (OR: 12.217) were significant factors for AF. RAA could partially mediate the relationship between LVRAS and AF according to the result of mediation analysis.Conclusions: Our study suggested that LVRAS, TR, LAD, mPAP, age and male were risk factors for AF. RA enlargement might underlie mechanism in the higher incidence of AF in LVRAS patients. These findings should be confirmed in larger prospective studies.

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Gerbode ventricular septum defect covered by a ballooning membranous ventricular septum

et al. 2012

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Real-time three-dimensional transesophageal echocardiography of the Gerbode defect

Cited by 5 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

Higher Incidence of Atrial Fibrillation in Left Ventricular-to-Right Atrial Shunt Patients

Gerbode ventricular septum defect covered by a ballooning membranous ventricular septum

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