Clinical SpotlightAcquired Gerbode Defects Associated with Infective Endocarditis
Introduction
Infective endocarditis is associated with a high risk of mortality and complications. A rare complication of endocarditis is acquired left ventricle to right atrium (Gerbode) defects. We present two complex cases of infective endocarditis with acquired Gerbode defects.
Section snippets
Case 1
A 68-year-old female presented to the pre-operative clinic for review prior to a planned right hemicolectomy for ascending colorectal cancer. Her medical history was significant for moderate asymptomatic aortic stenosis, hypertension, chronic kidney disease, iron deficiency anaemia and recent lower gastrointestinal bleeding requiring transfusion. She described a week-long history of worsening shortness of breath, orthopnoea and cough. Examination revealed a loud ejection systolic murmur and
Discussion
The two cases described illustrate an extremely rare complication of infective endocarditis: acquired left ventricle (LV) to right atrium (RA) defects. Gerbode's initial description of LV to RA shunts involved cases of congenital ventricular septal defects [1]. In both cases, it is plausible that the defects were acquired as a consequence of bacterial invasion of the membranous septum [2]. The first patient had a transthoracic echocardiogram performed four weeks prior to presentation which did
Conflict of Interest
None to declare
Acknowledgments
No financial assistance or conflicts of interest to disclose.
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