A spontaneously closed, acquired supravalvular Gerbode defect mimicking an unruptured sinus of Valsalva aneurysm

Hsu, Shun‐Yi; Shen, Ta-Chung

doi:10.1093/ehjci/jet192

Cited by 8 publications

(7 citation statements)

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“…[ 96 ] recommended that patients with no symptoms and no right ventricular volume or pressure overload due to a small LV-RA shunt were not indicated for surgery but close follow-up was recommended instead. In the surgical operations, a patch repair should be performed on the right atrial side in order to prevent atrioventricular block [ 59 , 94 ]. In long-term follow-up (up to 19.7 years) 17% of the LV-RA shunts spontaneously closed, while 8.5% developed IE during follow-up [ 105 ].…”

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: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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

Yuan¹

2014

pwki

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“…Gerbode described such a defect as a congenital atrioventricular shunt originating from the interventricular membranous septum with regurgitation into the right atrium through a defect or cleft in the tricuspid valve leaflet [ 2 ]. Less common is the acquired form of a Gerbode defect, which is often associated with bacterial endocarditis [ 5 – 24 ], myocardial infarction [ 25 – 27 ], blunt chest trauma [ 28 , 29 ] or post previous cardiac surgical procedures [ 30 , 31 ].…”

Section: Commentmentioning

confidence: 99%

“…Carpenter [ 23 ] 2012 Male/22 TV Staphylococcus lugdunensis TEE, CT Surgery Survived 20. Hsu [ 24 ] 2014 Male/40 BAV Cardiobacterium hominis TEE, Surgery Died(RF) 21. Prifti et al 2015 Female/40 TV Staphylococcus aureus TTE, TEE Surgery Survived Area of myocardial infarction 22.…”

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). The patient was managed conservatively in the hope that the shunt size would progressively decrease and become hemodynamically insignificant as had been described in the literature [4].…”

Section: To the Editormentioning

confidence: 99%

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

Ngu

Harper

Nasis

2016

International Journal of Cardiology

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A spontaneously closed, acquired supravalvular Gerbode defect mimicking an unruptured sinus of Valsalva aneurysm

Cited by 8 publications

References 0 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

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

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