Delayed left ventricular-to-right atrial communication (acquired Gerbode defect) after aortic valve replacement
- 141 Downloads
Left ventricular (LV)-to-right atrial (RA) communications, collectively known as Gerbode defects , are mostly congenital defects, but acquired cases are also described mainly following infective endocarditis, mitral and aortic valve replacement (AVR), thoracic trauma, or acute myocardial infarction [2, 3, 4, 5, 6, 7, 8]. Its clinical spectrum depends on the underlying etiology and the size of the defect. Symptoms of LV–RA shunts vary from none to severe heart failure and ultimately to death . Whereas small communications may be well tolerated without symptoms or clinical signs, the larger ones lead to volume overload, chamber enlargement, and eventually heart failure . We present an uncommon acquired LV-RA communication (acquired Gerbode-type defect) following an AVR in an asymptomatic patient.
A 43-year-old asymptomatic man who had undergone AVR 9 years earlier was referred for echocardiography as part of a routine postoperative evaluation. He had taken no...
KeywordsInfective Endocarditis Aortic Valve Replacement Ventricular Septal Defect Ventricular Septal Defect Percutaneous Closure
Verzögert aufgetretener Shunt zwischen linkem Ventrikel und rechtem Vorhof (erworbener Gerbode-Defekt) nach Aortenklappenersatz
Compliance with ethical guidelines
Conflict of interest. O. Ozeke, E. Celik, E. Grbovic, A. Colak, P. Dogan, O. Tufekcioglu, Z. Golbasi, H.L. Kisacik state that there are no conflicts of interest. The accompanying manuscript does not include studies on humans or animals.
Video 1. Transthoracic colour-flow Doppler echocardiography at parasternal short axis view showing two high-velocity systolic jet entering the RA from the RV ( tricuspid regurgitation) and from LV (Gerbode-type defect) (AVI 1,95MB)
Video 2. Transthoracic colour-flow Doppler echocardiography at apical 4-chamber view showing two high-velocity systolic jet entering the RA from the RV (consistent with a tricuspid regurgitation) and from LV (consistent with a Gerbode-type defect) (AVI 2,05 MB)
Video 3. Transthoracic colour-flow Doppler echocardiography at subcostal view showing two high-velocity systolic jet entering the RA from the RV (consistent with a tricuspid regurgitation) and from LV (consistent with a Gerbode-type defect) (AVI 1,81MB)
Video 4. Transthoracic colour-flow Doppler echocardiography at parasternal short axis view showing moderate periprosthetic leaks. (AVI 1,95MB)
Video 5. Contrast echocardiography showing no significant right-to-left shunt at the interatrial or interventricular level. (AVI 6,23MB)
- 10.Ozer N, Deniz A, Atalar E et al (2007) Aorta-right atrial fistula: a rare complication of prosthetic aortic valvular endocarditis. J Am Soc Echocardiogr 20:538.e5–e6Google Scholar
- 11.Warnes CA, Williams RG, Bashore TM et al (2008) ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation 118:e714–e833CrossRefPubMedGoogle Scholar