Tricuspid Endocarditis with Indirect Gerbode: Septal Translocation of Posterior Leaflet

Pillai, Vivek; Menon, Sabarinath; Kottayil, Brijesh P; Karunakaran, Jayakumar

doi:10.1016/j.hlc.2010.12.007

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…The 11 misdiagnosed patients were initially mistaken as tricuspid regurgitation [ 6 , 22 ] and tricuspid regurgitation and pulmonary artery hypertension [ 25 , 83 , 84 ] in 3 (27.3%) patients each and rupture of Valsalva aneurysm into the right atrium [ 14 ], prosthetic mitral valve leak [ 103 ], mitral valve regurgitation with prosthetic mitral valve leak [ 92 ], atrial septal defect [ 47 ] and residual VSD [ 8 ] in 1 (9.1%) patient each. There were 45 TTE images leading to misdiagnosis, missed diagnosis, or inclusive diagnosis in 33 patients, whose correct diagnoses were established mostly by alternative diagnostic techniques, with TEE being the most frequent ( Figure 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…Echocardiography was a gold standard for the diagnosis of the intracardiac shunts. However, the high velocity LV-RA jet may be misdiagnosed as tricuspid regurgitation with pulmonary artery hypertension [ 54 , 83 ]. 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 ].…”

Section: Discussionmentioning

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: 99%

Section: Discussionmentioning

confidence: 99%

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

Yuan¹

2014

pwki

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“…However, in Gerbode defect, the shunt flow, affected by the septal leaflet of the tricuspid valve, may change direction unexpectedly. So, it can mimic the direction of tricuspid regurgitation flow and made sonographers misrecognize as tricuspid regurgitation in the setting of severe pulmonary artery hypertension[ 3 ]. In this case, at first, the clinical physician thought about VSD and sent the patient to the sonographer for more detail.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous closure of congenital Gerbode defect using Nit-Occlud^® Lê VSD coil

Phan¹,

Kim²,

Nguyen³

2017

WJC

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We present a case report about percutaneous closure of a congenital Gerbode defect using Nit-Occlud® Lê VSD coil. The patient was referred to our hospital with a diagnosis of ventricular septal defect (VSD) and severe pulmonary arterial hypertension. But transthoracic echocardiography revealed a communication between the left ventricle (LV) and the right atrial (RA), called Gerbode defect. Catheterization confirmed the shunt from the LV to the RA. We successfully closed the defect with a VSD coil. After uneventful 6 mo follow-up, the patient was out of dyspnea, the symptom urged him to have medical attention. This case report is to discuss the diagnosis and percutaneous treatment approach for this rare congenital heart disease.

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“…Ota [ 21 ] 2011 Male/71 AV Streptococcus pneumonia TTE,TEE Surgery Survived 18. Pillai [ 22 ] 2011 Male/12 TV Culture negative TEE Surgery Survived 19. Carpenter [ 23 ] 2012 Male/22 TV Staphylococcus lugdunensis TEE, CT Surgery Survived 20.…”

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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Tricuspid Endocarditis with Indirect Gerbode: Septal Translocation of Posterior Leaflet

Cited by 5 publications

References 7 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

Percutaneous closure of congenital Gerbode defect using Nit-Occlud^® Lê VSD coil

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

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Tricuspid Endocarditis with Indirect Gerbode: Septal Translocation of Posterior Leaflet

Cited by 5 publications

References 7 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

Percutaneous closure of congenital Gerbode defect using Nit-Occlud® Lê VSD coil

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

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Percutaneous closure of congenital Gerbode defect using Nit-Occlud^® Lê VSD coil