Left Ventricular–Right Atrial Communication with Third-degree Atrioventricular Block after Thoracic Trauma

Portet, Nicolas; Riu, Béatrice; Bounes, Vincent; Minville, Vincent; Fourcade, Olivier

doi:10.1016/j.jemermed.2010.11.059

Cited by 4 publications

(3 citation statements)

References 2 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…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%

“…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%

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: Methodsmentioning

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

“…Atrio-ventricular conduction disturbances have been reported, although this was not the case in our patient. [ 14 15 ]…”

Section: Discussionmentioning

confidence: 99%

Simultaneous "traumatic Gerbode" and aortic rupture due to blunt chest trauma

Anninos¹,

Baikoussis

Dedeilias³

et al. 2016

Ann Card Anaesth

View full text Add to dashboard Cite

The Gerbode defect is characterized by a perimembranous ventricular septal defect between the left ventricle and the right atrium. This intracardiac shunt is a congenital defect but may be iatrogenic after valve surgery or atrioventricular node ablation, may be the result of endocarditis or may be traumatic. It is really rarely encountered as sequelae of non-penetrating heart trauma, and their clinical manifestations may often be unrecognized in the multi-injured patient. However, they are serious complications, and their diagnostic approach is not always feasible. We hereby present a case of a young man with the left ventricle to the right atrium communication after blunt thoracic trauma due to a car accident and concomitant rupture of the thoracic aorta. We present also the case and the ways of treatment according to the international bibliography.

show abstract

Acquired left ventricle-to-right atrium shunt: clinical implications and diagnostic dilemmas

Yuan

2015

Wien Klin Wochenschr

View full text Add to dashboard Cite

A high jet detected in the right atrium with uncertain origin and course has to appeal to additional diagnostic techniques including transesophageal echocardiography, cardiac catheterization, or cardiac magnetic resonance imaging for differential diagnoses. Small restrictive shunts are preferred with conservative treatments, high-risk patients are candidates of interventional therapy, and the patients with unstable hemodynamics warrant an open heart surgery. Careful operative maneuver, good control of intracardiac infection, preservation of heart function, etc., are mandatory for the prevention of the development of an acquired LV-RA shunt.

show abstract

Left Ventricular–Right Atrial Communication with Third-degree Atrioventricular Block after Thoracic Trauma

Cited by 4 publications

References 2 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

Simultaneous "traumatic Gerbode" and aortic rupture due to blunt chest trauma

Acquired left ventricle-to-right atrium shunt: clinical implications and diagnostic dilemmas

Contact Info

Product

Resources

About