A Gerbode defect is a very rare type of congenital anomaly with a direct communication between left ventricle and right atrium leading to Left to Right shunt. This defect was first reported by Meyer in 1857. First successful closure was done by Kerby et al using hypothermia and inflow occlusion technique. It may present as a direct or indirect type. With improvements in nomenclature and taxonomy that expanded the classification until the current modifications were in place that accounted for defect type and position with respect to the Tricuspid Valve. Now, it is broadly described as Supravalvular type and infravalvular type. The etiology is typically congenital with irregularities emerging by perforation of anterior intraventricular septum, malformation of leaflets, or widening of the commissural space. These embryological deviations subsequently permit an abnormal communication that begins the physiological processes leading to the pathology. Shunt depends on the size of the defect and PVR. Shunt flow begins inutero because of the obligatory difference in the systolic pressure between LV and RA. RA accepts shunt with less or no elevation of pressures due to distensibility. We report a 8 year old female child who presented with dyspnea on exertion and recurrent respiratory infections whose echocardiography confirmed a direct type (supravalvular) Gerbode defect. This was confirmed by cath study and during surgery. She underwent successful suture closure of the shunt using a Goretex patch. This is a case of direct type Gerbode defect doing well after surgery.
| Published in | International Journal of Cardiovascular and Thoracic Surgery (Volume 5, Issue 6) |
| DOI | 10.11648/j.ijcts.20190506.11 |
| Page(s) | 76-79 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2019. Published by Science Publishing Group |
Gerbode Defect, Congenital Anomaly, Left to Right Shunt, Direct, Indirect, Ventricular Septal Defect, Tricuspid Valve
| [1] | Meyer H. Ueberangeborene Engeoder Verschluss der Lungenarterienbahn. Archiv für Pathologische Anatomie und Physiologie und fσ¼r Klinische Medicin. 1857; 12 (6): 497–538. [Google Scholar]. |
| [2] | Kirby C, Johnson J, Zinsser H. Successful Closure of a Left Ventricular-Right Atrial Shunt. Annals of Surgery. 1957; 145 (3): 392–94. [PMC free article] [PubMed] [Google Scholar]. |
| [3] | Gerbode F, Hultgren H, Melrose D, Osborn J. Syndrome of left ventricular-right atrial shunt successful surgical repair of defect in five cases, with observation of bradycardia on closure. Annals of Surgery. 1958; 148 (3): 433–46. [PMC free article] [PubMed] [Google Scholar]. |
| [4] | Riemenschneider TA, Moss AJ. Left ventricular-right atrial communication. Am J Cardiol 1967; 19: 710–8. |
| [5] | Jacobs J, Burke R, Quintessenza J, Mavroudis C. Congenital Heart Surgery nomenclature and database project: ventricular septal defect. The Annals of Thoracic Surgery. 2000; 69 (3): 25–35. [PubMed] [Google Scholar]. |
| [6] | O. M. Cheema, A. A. Patel, M. C. Su, and D. J. Shah, “Gerbode ventricular septal defect diagnosed at cardiacMR imaging: case report,” Radiology, vol. 252, no. 1, pp. 50–52, 2009. |
| [7] | Yuan S. A systematic review of acquired left ventricle to right atrium shunts (Gerbode defects). Hellenic J Cardiol 2015; 56: 357–72. |
| [8] | Thurnam J. On aneurisms of the heart with cases. Med Chir Trans 1838; 21: 187. |
| [9] | Brili SV, Barberis VI, Karamitros IA, Fourlas CA, Stefanadis CI. Mild cyanosis due to coexistence of congenitally corrected transposition of the great arteries and Gerbode-type defect. Cardiology 2006; 105: 41–2. |
| [10] | Vizzari G, Pizzino F, Crouch JD, Ammar KA, Gal A, Khandheria BK, et al.. Congential Gerbode defect in a patient with an acute myocardial infarction and cardiogenic shock masquerading as an acute ventricular septal defect. J Cardiothorac Vasc Anesth 2015; 29: 1311–3. |
| [11] | Apostolakis S, Konstantinides S. The right ventricle in health and disease: insights into physiology, pathophysiology, and diagnostic management. Cardiology 2012; 4: 263–73. |
| [12] | Loukas M, Klaassen Z, Tubbs RS. Anatomical observations of the moderator band. Clin Anat 2010; 23: 443–50. |
| [13] | Allwork SP, Anderson RH. Developmental anatomy of the membranous part of the ventricular septum in the human heart. Br Heart J 1979; 4: 275–80. |
| [14] | Lin CJ, Lin CY, Chen CH, Zhou B, Chang CP. Partitioning the heart: mechanisms of cardiac septation and valve development. Development 2012; 139: 3277–9. |
| [15] | Grignola JC. Hemodynamic assessment of pulmonary hypertension. World J Cardiol 2011; 3: 10–7. |
| [16] | Taskesen T, Prouse AF, Goldberg SL, Gill EA. Gerbode defect: another nail for the 3D transesophagel echo hammer? Int J Cardiovasc Imaging 2015; 31: 753–64. |
| [17] | Silbiger JJ, Kamran M, Handwerker S, Kumar N, Marcali M. The Gerbode defect: left ventricular to right atrial communication—anatomic, hemodynamic, and echocardiographic features. Echocardiography 2009; 26: 993–8. |
| [18] | Acar P, Seguela PE, Hascoet S. The Gerbode defect or left ventricular to right atrial shunt assessed by transthoracic 3D echocardiography. Echocardiography 2011; 28: E140–2. |
| [19] | Yared K, Solis J, Passeri J, King ME, Levine RA. Three dimensional echocardiographic assessment of acquired left ventricular to right atrial shunt (Gerbode defect). J Am Soc Echocardiogr 2009; 22: 435.e. |
| [20] | Hansalia S, Manda J, Pothineni KR, Nanda NC. Usefulness of live/real time three-dimensional transthoracic echocardiogra-phy in diagnosing acquired left ventricular–right atrial communication misdiagnosed as severe pulmonary hypertension by two-dimensional transthoracic echocardiography. Echocardiography 2009; 26: 224–7. |
| [21] | Notarangelo MF, Bontardelli F, Taliani U, Agostinelli A, Vignali L, Ardissino D. A rare ventricular septal defect: a case report. G Ital Cardiol 2013; 14: 283–5. |
APA Style
Anirudh Kumar Paidi, Palli Venkata Naresh Kumar, Ravikanth Vanguri, Rajasekhar Varada, Madhav Rao Midhe, et al. (2019). A Rare Case of Gerbode Defect and Review of Literature. International Journal of Cardiovascular and Thoracic Surgery, 5(6), 76-79. https://doi.org/10.11648/j.ijcts.20190506.11
ACS Style
Anirudh Kumar Paidi; Palli Venkata Naresh Kumar; Ravikanth Vanguri; Rajasekhar Varada; Madhav Rao Midhe, et al. A Rare Case of Gerbode Defect and Review of Literature. Int. J. Cardiovasc. Thorac. Surg. 2019, 5(6), 76-79. doi: 10.11648/j.ijcts.20190506.11
AMA Style
Anirudh Kumar Paidi, Palli Venkata Naresh Kumar, Ravikanth Vanguri, Rajasekhar Varada, Madhav Rao Midhe, et al. A Rare Case of Gerbode Defect and Review of Literature. Int J Cardiovasc Thorac Surg. 2019;5(6):76-79. doi: 10.11648/j.ijcts.20190506.11
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.ijcts.20190506.11,
author = {Anirudh Kumar Paidi and Palli Venkata Naresh Kumar and Ravikanth Vanguri and Rajasekhar Varada and Madhav Rao Midhe and Ravi Kiran Mamidala},
title = {A Rare Case of Gerbode Defect and Review of Literature},
journal = {International Journal of Cardiovascular and Thoracic Surgery},
volume = {5},
number = {6},
pages = {76-79},
doi = {10.11648/j.ijcts.20190506.11},
url = {https://doi.org/10.11648/j.ijcts.20190506.11},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijcts.20190506.11},
abstract = {A Gerbode defect is a very rare type of congenital anomaly with a direct communication between left ventricle and right atrium leading to Left to Right shunt. This defect was first reported by Meyer in 1857. First successful closure was done by Kerby et al using hypothermia and inflow occlusion technique. It may present as a direct or indirect type. With improvements in nomenclature and taxonomy that expanded the classification until the current modifications were in place that accounted for defect type and position with respect to the Tricuspid Valve. Now, it is broadly described as Supravalvular type and infravalvular type. The etiology is typically congenital with irregularities emerging by perforation of anterior intraventricular septum, malformation of leaflets, or widening of the commissural space. These embryological deviations subsequently permit an abnormal communication that begins the physiological processes leading to the pathology. Shunt depends on the size of the defect and PVR. Shunt flow begins inutero because of the obligatory difference in the systolic pressure between LV and RA. RA accepts shunt with less or no elevation of pressures due to distensibility. We report a 8 year old female child who presented with dyspnea on exertion and recurrent respiratory infections whose echocardiography confirmed a direct type (supravalvular) Gerbode defect. This was confirmed by cath study and during surgery. She underwent successful suture closure of the shunt using a Goretex patch. This is a case of direct type Gerbode defect doing well after surgery.},
year = {2019}
}
TY - JOUR T1 - A Rare Case of Gerbode Defect and Review of Literature AU - Anirudh Kumar Paidi AU - Palli Venkata Naresh Kumar AU - Ravikanth Vanguri AU - Rajasekhar Varada AU - Madhav Rao Midhe AU - Ravi Kiran Mamidala Y1 - 2019/11/25 PY - 2019 N1 - https://doi.org/10.11648/j.ijcts.20190506.11 DO - 10.11648/j.ijcts.20190506.11 T2 - International Journal of Cardiovascular and Thoracic Surgery JF - International Journal of Cardiovascular and Thoracic Surgery JO - International Journal of Cardiovascular and Thoracic Surgery SP - 76 EP - 79 PB - Science Publishing Group SN - 2575-4882 UR - https://doi.org/10.11648/j.ijcts.20190506.11 AB - A Gerbode defect is a very rare type of congenital anomaly with a direct communication between left ventricle and right atrium leading to Left to Right shunt. This defect was first reported by Meyer in 1857. First successful closure was done by Kerby et al using hypothermia and inflow occlusion technique. It may present as a direct or indirect type. With improvements in nomenclature and taxonomy that expanded the classification until the current modifications were in place that accounted for defect type and position with respect to the Tricuspid Valve. Now, it is broadly described as Supravalvular type and infravalvular type. The etiology is typically congenital with irregularities emerging by perforation of anterior intraventricular septum, malformation of leaflets, or widening of the commissural space. These embryological deviations subsequently permit an abnormal communication that begins the physiological processes leading to the pathology. Shunt depends on the size of the defect and PVR. Shunt flow begins inutero because of the obligatory difference in the systolic pressure between LV and RA. RA accepts shunt with less or no elevation of pressures due to distensibility. We report a 8 year old female child who presented with dyspnea on exertion and recurrent respiratory infections whose echocardiography confirmed a direct type (supravalvular) Gerbode defect. This was confirmed by cath study and during surgery. She underwent successful suture closure of the shunt using a Goretex patch. This is a case of direct type Gerbode defect doing well after surgery. VL - 5 IS - 6 ER -
Information
Email: