Gerbode defect: Another nail for the 3D transesophagel echo hammer?

  • Tuncay Taskesen
  • Andrew Fred Prouse
  • Steven Lewis Goldberg
  • Edward Allen Gill
Review Paper

Abstract

Acquired type of LV to RA shunt (Gerbode defect) is rare form of intracardiac shunt which is due to complications of invasive cardiac procedures, endocarditis, trauma or myocardial infarction. Increasing invasive and recurrent cardiovascular procedures have led to more acquired cases of what used to be a predominant congenital heart defect. Advanced cardiac imaging techniques and awareness of this rare pathology may account for the increased number of case reports in the last two decades Advanced cardiac imaging tools such as cardiac CT, MRI and Real-time 3D echocardiography provide definitive diagnosis and anatomic characterization of the shunt. Real-time 3D echocardiography is an imaging technique with arguably the most advantages. It is not only a diagnostic tool; it has also become an integral part of percutaneous and surgical treatment. Although surgical repair is the usual treatment for this shunt, percutaneous catheter-based closure has seen significant success as a less invasive treatment in selected patients in the last decade. In summary, a beneficial side effect of the increasing frequency of acquired Gerbode defect has been the corresponding development of newer diagnostic tools and less invasive treatments. This article presents etiologic, diagnostic and treatment changes of acquired LVRA shunts over the last two decades.

Keywords

LV–RA shunt 3D Echocardiography Gerbode defect Tricuspid valve Ventriculoatrial shunt 

Abbreviations

AGD

Acquired Gerbode defect

AIGD

Acquired iatrogenic Gerbode defect

ANIGD

Acquired noniatrogenic Gerbode defect

CT

Computer tomography

2D

Two-dimensional

3D

Three-dimensional

LV

Left ventricle

MI

Myocardial infarction

MRI

Magnetic resonance imaging

TTE

Transthoracic echocardiography

TEE

Transesophageal echocardiography

RA

Right atrium

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Copyright information

© Springer Science+Business Media Dordrecht 2015

Authors and Affiliations

  • Tuncay Taskesen
    • 1
  • Andrew Fred Prouse
    • 2
  • Steven Lewis Goldberg
    • 3
  • Edward Allen Gill
    • 1
    • 3
  1. 1.Division of CardiologyHarborview Medical CenterSeattleUSA
  2. 2.Division of Pulmonary Critical CareUniversity of Washington Medical CenterSeattleUSA
  3. 3.Cardiology DivisionUniversity of Washington Medical CenterSeattleUSA

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