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01.12.2012 | Case report | Ausgabe 1/2012 Open Access

Cardiovascular Ultrasound 1/2012

Uncommon acquired Gerbodedefect following extensive bicuspid aortic valve endocarditis

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2012
Autoren:
Hélder Dores, João Abecasis, Regina Ribeiras, José Pedro Neves, Miguel Mendes
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-10-7) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests (there are not disclosures of any relationship with industry).

Authors' contributions

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.

Abstract

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.
Zusatzmaterial
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)
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Additional file 2: Clip S2. Color Doppler imaging by suprasternal view depicting diastolic flow reversal at the descending thoracic aorta. (AVI 2 MB)
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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)
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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)
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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)
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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)
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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)
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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)
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Authors’ original file for figure 1
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Authors’ original file for figure 2
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Authors’ original file for figure 3
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