Gerbode defect misinterpreted as pulmonary hypertension

Garg, Ruchira; Garcia, Richard U.; Cubeddu, Robert J.

doi:10.1016/j.jccase.2012.10.002

Cited by 8 publications

(6 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Fever (8 patients, 9.1%) was a more common symptom in the acquired group patients. Aortic wall abscesses were seen in 9 patients (10.2%) [ 33 , 39 , 40 , 53 , 55 , 58 , 78 , 87 , 104 ] and atrioventricular block in 12 (13.6%) (2 were with aortic wall abscess [ 39 , 61 ], 6 were third degree [ 39 , 61 , 82 , 89 , 99 , 102 ] and 6 were first degree [ 18 , 44 , 48 , 86 , 101 , 102 ]) of the acquired group patients but in none in the congenital patients. There was significant dominance of right atrium dilation, right ventricle dilation, tricuspid regurgitation and pulmonary artery hypertension ( Table I ).…”

Section: Resultsmentioning

confidence: 99%

“…The mechanisms of the congenital LV-RA shunt from an embryologic viewpoint have not been fully described. The acquired LV-RA shunts may be caused by weakened membranous septum due to a previous operation [ 53 ], vegetation invasions of the membranous septum in IE [ 49 ], perforation of the upper portion of the membranous septum caused by an infection from IE in spite of the lack of vegetation [ 71 ], extended decalcification of the annulus in the posteromedial commissure or its vicinity during valve replacements [ 36 , 51 ], or a tear in the tricuspid annulus at the membranous septum resulting in membranous septal injury [ 36 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Yuan¹

2014

pwki

View full text Add to dashboard Cite

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.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Yuan¹

2014

pwki

View full text Add to dashboard Cite

show abstract

“…A characteristic finding of Gerbode defect is an increase in oxygen saturation between the superior vena cava and the RA [1,32,59]. The presence of a shunt can be confirmed by left ventriculography with contrast opacification of the RA prior to the RV, originating from the LV [7,60]. Despite its diagnostic importance for hemodynamic evaluation and clarification of complex setups, cardiac catheterization has been replaced by noninvasive cardiac imaging techniques [46].…”

Section: Cardiac Catheterizationmentioning

confidence: 99%

Congenital Gerbode Defect: A Left Ventricular to Right Atrial Shunt—State-of-the-Art Review of Its General Data, Diagnostic Modalities, and Treatment Strategies

Winter,

Strizek,

Recker

2024

JCDD

View full text Add to dashboard Cite

The congenital Gerbode defect is defined as an abnormal communication between the left ventricle and the right atrium. This review aimed to summarize existing evidence, shed light on the clinical implications, and identify knowledge gaps. The systematic literature search was conducted in the PubMed and Google Scholar medical databases using specifically selected keywords. The inclusion of each publication was assessed according to predefined eligibility criteria based on the PICOM (Population, Phenomenon of Interest, Context, Methodology) schema. Titles and abstracts were screened independently by two authors. Available full-text versions of included publications were reviewed and relevant information was extracted. A total of 78 reports were included. The compilation of all congenital Gerbode defect cases described in the literature revealed a variety of clinical presentations comprising dyspnea, palpitations, growth retardation, and asymptomatology. A suitable multimodal diagnostic approach for newborns consists of auscultation, TTE, and optionally TEE and MRI. Because of its rarity, diversity of findings, unknown pathophysiology, and similarity to more common cardiac diseases, the diagnostic challenge remains significant. To prevent untreated long-term sequelae, early individualized treatment is recommended. Surgical defect closure is preferred to device closure for evidence reasons, although major developments are currently taking place. In conclusion, the congenital Gerbode defect provides a diagnostic challenge for pediatricians to allow early diagnosis and intervention in order to improve patients’ quality of life.

show abstract

“…El tratamiento del DG depende de los síntomas, severidad del shunt, defectos valvulares anexos, volumen de regurgitación y comorbilidades, siendo necesario el manejo de la patología basal, como endocarditis en caso de haberla [11], además de requerir, en la mayoría de los casos, intervención quirúrgica [1]. Sin embargo, los defectos pequeños, crónicos y asintomáticos pueden manejarse de forma conservadora [4].…”

Section: Defecto De Gerbodeunclassified

Defecto de Gerbode: Reporte de un caso

2022

Rev. chil. anest.

View full text Add to dashboard Cite

Gerbode defect (DG) is a very rare condition that consists of a communication from the left ventricle (LV) to the right atrium (RA) due to a septal defect, which may be congenital or acquired, secondary to endocarditis, valve replacement surgery, acute myocardial infarction, or chest trauma. A shunt is produced from a high-pressure chamber to a low-pressure chamber, increasing the volume and pressure of the right chambers, which can produce mixed circulatory failure due to dysfunction of these cavities and low output due to LV systolic volume. Cardiac ultrasound is the gold standard in the study and diagnosis of this pathology. Treatment can be by surgical or percutaneous intervention. The case of a patient with Gerbode defect secondary to valve replacement will be presented, where the ultrasound diagnosis was essential to perform a surgical repair in the ward.

show abstract

Gerbode defect misinterpreted as pulmonary hypertension

Cited by 8 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

Congenital Gerbode Defect: A Left Ventricular to Right Atrial Shunt—State-of-the-Art Review of Its General Data, Diagnostic Modalities, and Treatment Strategies

Defecto de Gerbode: Reporte de un caso

Contact Info

Product

Resources

About