The online version of this article (doi:10.1186/1476-7120-10-7) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests (there are not disclosures of any relationship with industry).
All other authors were directly involved in patient management and written report. HD is a cardiology resident at the Cardiology Department of Hospital de Santa Cruz, Carnaxide - Portugal (the corresponding author of the manuscript), being particularly involved in the clinical assessment and follow-up of the patient presented in the reported case. He is also responsible for the main written case report. JA and RR were responsible for the first echocardiographic evaluation and diagnosis. JPN was the cardiothoracic surgeon being the director in chief of the Cardiothoracic Surgery Department. MM is the head director of the Cardiology Department. All authors read and approved the manuscript. The present report has not been previously published.
Gerbode defect is a rare type of left ventricle to right atrium shunt. It is usually congenital in origin, but acquired cases are also described, mainly following infective endocarditis, valve replacement, trauma or acute myocardial infarction. We report a case of a 50-year-old man who suffered an extensive and complex infective endocarditis involving a bicuspid aortic valve, the mitral-aortic intervalvular fibrosa and the anterior leaflet of the mitral valve. After dual valve replacement and annular reconstruction, a shunt between the left ventricle and the right atrium - Gerbode defect, and a severe leak of the mitral prosthesis were detected. Reintervention was performed with successful shunt closure with an autologous pericardial patch and paravalvular leak correction. No major complications occurred denying the immediate post-surgery period and the follow-up at the first year was uneventful.
Additional file 1: Clip S1. Parasternal long axis view revealing an echogenic, pediculated and mobile mass attached to the atrial side of the anterior leaflet of the mitral valve. (AVI 5 MB)12947_2011_410_MOESM1_ESM.avi
Additional file 2: Clip S2. Color Doppler imaging by suprasternal view depicting diastolic flow reversal at the descending thoracic aorta. (AVI 2 MB)12947_2011_410_MOESM2_ESM.avi
Additional file 3: Clip S3. Transthoracic apical view showing two mitral valve regurgitation jets, one of them in possible correlation with an anterior leaflet perforation. (AVI 4 MB)12947_2011_410_MOESM3_ESM.avi
Additional file 5: Clip S5 and Clip S6. Abnormal systolic jet between the left ventricle and the right atrium above the tricuspid valve (parasternal short axis view - Clip S5 and subcostal four chambers view - Clip S6). (AVI 5 MB)12947_2011_410_MOESM5_ESM.avi
Additional file 6: Clip S5 and Clip S6. Abnormal systolic jet between the left ventricle and the right atrium above the tricuspid valve (parasternal short axis view - Clip S5 and subcostal four chambers view - Clip S6). (AVI 4 MB)12947_2011_410_MOESM6_ESM.avi
Additional file 7: Clip S7 and Clip S8. An abnormal systolic jet entering the right atrium was seen at a high esophageal view (Clip S7). A moderate-to-severe peri-prosthetic leak was also evident (Clip S8). (AVI 2 MB)12947_2011_410_MOESM7_ESM.avi
Additional file 8: Clip S7 and Clip S8. An abnormal systolic jet entering the right atrium was seen at a high esophageal view (Clip S7). A moderate-to-severe peri-prosthetic leak was also evident (Clip S8). (AVI 2 MB)12947_2011_410_MOESM8_ESM.avi
Additional file 9: Clip S9. Transthoracic echocardiogram - parasternal short axis view performed during the follow-up showing the absence of the shunt between the left ventricle and the right atrium. (AVI 6 MB)12947_2011_410_MOESM9_ESM.avi
Authors’ original file for figure 112947_2011_410_MOESM10_ESM.tiff
Authors’ original file for figure 212947_2011_410_MOESM11_ESM.tiff
Authors’ original file for figure 312947_2011_410_MOESM12_ESM.tiff
Doig JC, Au J, Dark JH, Furniss SS: Post-infarction communication between a left ventricular aneurysm and the right atrium. Eur Heart J. 1992, 13: 1006-1007. PubMed
Daakhah R, Friart A, Leclerc JL, Moreels M, Haberman D, Lienart F: Uncommon acquired Gerbode defect (left ventricular to right atrial communication) following a tricuspid annuloplasty concomitant mitral surgery. Eur J Echocardiograf. 2009, 10: 579-581. 10.1093/ejechocard/jep035. CrossRef
Hori D, Tanaka M, Yamagushi A, Adachi H: Surgically treated infective endocarditis involving the aortic bicuspid valve and ventricular septum revealing aortic regurgitation and a Gerbode defect. Gen Cardiovasc Surg. 2010, 58: 255-259. 10.1007/s11748-009-0524-z. CrossRef
Ota T, Yamaguchi R, Tanigawa T, Otuka K, Hayashi Y, Nishiyama H, Tsumori T, Kamimori K, Yanagi S, Ishikawa I: Left ventricular-right atrial communication by perforation of the atrioventricular portion of the membranous septum and severe valve regurgitation caused by infective endocarditis. J Echocardiogr. 2010, 9: 30-32. CrossRefPubMed
- Uncommon acquired Gerbodedefect following extensive bicuspid aortic valve endocarditis
José Pedro Neves
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II