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

Infective endocarditis is a severe disease with high mortality. Despite a global trend towards an increase in staphylococcal aetiologies, in older patients and a decrease in viridans streptococci, we have observed in recent studies great epidemiologic disparities between countries. In order to evaluate these differences among Mediterranean countries, we performed a PubMed search of infective endocarditis case series for each country. Data were available for 13 of the 18 Mediterranean countries. Despite great differences in diagnostic strategies, we could classify countries into three groups. In northern countries, patients are older (>50 years old), have a high rate of prosthetic valves or cardiac electronic implantable devices and the main causative agent is Staphylococcus aureus. In southern countries, patients are younger (<40 years old), rheumatic heart disease remains a major risk factor (45–93%), viridans streptococci are the main pathogens, zoonotic and arthropod-borne agents are frequent and blood culture–negative endocarditis remains highly prevalent. Eastern Mediterranean countries exhibit an intermediate situation: patients are 45 to 60 years old, the incidence of rheumatic heart disease ranges from 8% to 66%, viridans streptococci play a predominant role and zoonotic and arthropod-borne diseases, in particular brucellosis, are identified in up to 12% of cases.

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“…No data were available on IE in Albania, except a few cases reports of S. aureus [7] , [8] and Streptococcus bovis [9] endocarditis.…”

Section: Resultsmentioning

confidence: 99%

Endocarditis in the Mediterranean Basin

Gouriet¹,

Chaudet

Pellegrin

et al. 2018

New Microbes and New Infections

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“…It has been reported that LV-RA shunts in association with VSDs increases the risk of endocarditis (58 per 10,000 patient–years) in comparison to typical VSDs or mitral regurgitation (5.2 per 10,000 patient–years) [15], [32]. MI associated ANIGD has been reported with inferior wall MI with the LV-RA shunt located in the basal septum but not anterior wall MI [37], [39], [72], [73]. LV-RA shunt caused by MI has a mortality rate of 80% [9].…”

Section: Pathophysiologymentioning

confidence: 99%

“…Such defects are believed to close by forming an aneurysmal pouch through incorporating adjacent TV tissue. This morphogenetic process has been termed aneurysmal transformation [24], [32], [37], [38].…”

Section: Embryology and Pathologic Anatomymentioning

confidence: 99%

“…The major causes for ANIGD are endocarditis, myocardial infarction (MI) in the right coronary artery distribution [9], [15], [24], [37], [60], [61], [62], and blunt cardiac trauma [13], [63], [64], [65]. Though rare, endocarditis ranks second among causes for acquired LV-RA [7].…”

Section: Pathophysiologymentioning

confidence: 99%

“…From 1994–2004, there were eight reported cases, compared to 2005–2014, when there were 20 new cases [13]. These cases included prosthetic valve endocarditis (7 cases) and native valve endocarditis [9], [37], [66], [67], [68], [69], [70] of the aortic valve (14 cases), TV (9 cases), and mitral valve (5 cases).…”

Section: Pathophysiologymentioning

confidence: 99%

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

Saker

Bahri

Montalbano

et al. 2017

Journal of the Saudi Heart Association

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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.

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Ruptured Sinus of Valsalva Aneurysm and Gerbode Defects: Patient and Procedural Selection: the Key to Optimising Outcomes

Breatnach

Walsh

2018

Curr Cardiol Rep

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While transthoracic echocardiography is often diagnostic, transesophageal echocardiography (2D and 3D) has improved our understanding of these defects and allowed us to more accurately define their anatomy. Cardiac MRI provides improved assessment of the physiological impact of defects by quantifying shunt volume. Transcatheter techniques are currently vying with surgery as the mainstay of treatment. New insights are being discovered regarding diagnostic modalities and treatment pathways. Defining criteria for patient selection for catheter or surgical therapy is essential when deciding on the optimum intervention for the individual patient.

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

Cited by 30 publications

References 25 publications

Endocarditis in the Mediterranean Basin

Endocarditis in the Mediterranean Basin

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

Ruptured Sinus of Valsalva Aneurysm and Gerbode Defects: Patient and Procedural Selection: the Key to Optimising Outcomes

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