Transcatheter closure of acquired left ventricle to right atrium shunts

Abstract

We describe transcatheter closure of an acquired Gerbode defect (left ventricle to right atrium shunt) in four patients, ranging in age from 8 to 75 years. All of them had undergone previous surgery (VSD closure in 3, aortic valve replacement in 1), and either had persistent symptoms of heart failure, or developed new symptoms several months or years later. The diagnosis was made by one of several imaging modalities (transthoracic or transesophageal echocardiography, or MRI), and confirmed at cardiac catheterization. Device closure using a variety of devices was successful in all, with resolution of symptoms. One patient developed complete heart block, requiring permanent pacemaker implantation. Transcatheter closure is effective, and may replace surgery in the management of these defects.

Amplatzer duct occluder ii for closure of congenital Gerbode defects

“…The first successful series of patients operated on with a left ventricular to right atrial shunt was reported by Gerbode et al . There are a few case reports of percutaneous closure of acquired Gerbode shunts . There is a small series of four cases of post‐surgical Gerbode defects closed successfully with various devices.…”

“…There is a small series of four cases of post‐surgical Gerbode defects closed successfully with various devices. In their series, one patient developed complete heart block, requiring permanent pacemaker implantation . We had reported the transcatheter closure of four cases of congenital Gerbode defects earlier .…”

“…These shunts are traditionally closed surgically with high incidence of complete heart block. There are case reports and small series of mostly acquired and few congenital Gerbode defects closed percutaneously with various types of devices . We report a small series of 12 cases of only congenital Gerbode defects closed with Amplatzer duct occluder II (ADO II) which is specially designed to close long tubular duct in infants.…”

Percutaneous Closure of 2 Paravalvular Leaks and a Gerbode Defect after Mitral Valve Replacement for Infective Endocarditis

“…Surgery is the treatment of choice; however, percutaneous closure with septal occluders has been used as an alternative. 10,11 Sinisalo and colleagues 10 and Rothman and associates 12 reported using Amplatzer Duct, VSD, and ASD Occluders that had waist diameters slightly larger than the diameters of their patients' Gerbode defects. In our patient, closure with use of a 7-mm AVP IV device failed; an 8-mm Amplatzer VSD Occluder better fit the anatomy of the defect.…”

Percutaneous repair of acquired Gerbode defect complicated by hemolysis and acute kidney injury

“…If hemodynamically significant, they result in volume loading of both ventricles and may lead to heart failure. The standard of care for significant Gerbode defects is closure with surgical patch repair, though several recent case reports exist of defect closure using percutaneous devices [3].…”