American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(7), 372-374
DOI: 10.12691/ajmcr-9-7-8
Open AccessCase Report

Recurrence of Gerbode Defect despite Surgical Repair in a Patient with Bacterial Endocarditis

Sufyan AbdulMujeeb1, , Faisal Masood1, Syed Hussain2 and Adib Chaus3

1Department of Internal Medicine, Advocate Lutheran General Hospital, Park Ridge, IL, USA

2Department of Internal Medicine, McLaren Greater Lansing Hospital, Lansing, USA

3Department of Cardiology, Advocate Lutheran General Hospital, Park Ridge, IL, USA

Pub. Date: April 16, 2021

Cite this paper:
Sufyan AbdulMujeeb, Faisal Masood, Syed Hussain and Adib Chaus. Recurrence of Gerbode Defect despite Surgical Repair in a Patient with Bacterial Endocarditis. American Journal of Medical Case Reports. 2021; 9(7):372-374. doi: 10.12691/ajmcr-9-7-8

Abstract

Gerbode defect refers to an abnormal communication of the left ventricle (LV) with the right atrium (RA), causing a severe left-to-right shunt. Symptoms of gerbode defect depend on the degree of communication between LV and RA. This defect can be congenital or acquired. Some etiologies of acquired gerbode defect include cardiac trauma, myocardial ischemia, a complication of prior cardiac surgery, or bacterial endocarditis. Regardless of the etiology, surgical intervention involving the closure of the defect is the definitive treatment of this rare anatomical anomaly. We present the case of a young man with an acquired gerbode defect as a complication of bacterial endocarditis for which he underwent surgical correction. He later had a recurrence and worsening of left-to-right shunt via the gerbode defect a few days after the first surgery, requiring another surgical intervention. To our knowledge, recurrence of this defect after a surgical repair has so far not been reported in the literature. Therefore, we conclude that patients presenting with symptoms of severe right heart failure in whom prior surgical repair of the gerbode defect is performed should prompt clinicians to rule out recurrence of this defect.

Keywords:
Gerbode defect AV block Left-to-right shunt Hepatic congestion right heart failure

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References:

[1]  Velebit V, Schöneberger A, Ciaroni S, Bloch A, Maurice J, Christenson JT, et al. "Acquired" left ventricular-to-right atrial shunt (Gerbode defect) after bacterial endocarditis. Tex Heart Inst J. 1995; 22(1): 100-2. PMID: 7787460; PMCID: PMC325219.
 
[2]  Barclay RS, Reid JM, Coleman EN, Stevenson JG, Welsh TM, McSwan EN. Communication between Left Ventricle and Right Atrium. Thorax, 1967, https://thorax.bmj.com/content/thoraxjnl/22/5/473.full.pdf.
 
[3]  Prifti E, Ademaj F, Baboci A. et al. Acquired Gerbode defect following endocarditis of the tricuspid valve: a case report and literature review. J Cardiothorac Surg 10, 115 (2015).
 
[4]  Saker E, Bahri GN, Montalbano MJ, Johal J, Graham RA, Tardieu GG, Loukas M, Tubbs RS. Gerbode defect: A comprehensive review of its history, anatomy, embryology, pathophysiology, diagnosis, and treatment. J Saudi Heart Assoc. 2017 Oct; 29(4): 283-292.
 
[5]  Taskesen, T., Prouse, A.F., Goldberg, S.L. et al. Gerbode defect: Another nail for the 3D transesophageal echo hammer? Int J Cardiovasc Imaging 31, 753-764 (2015).
 
[6]  AbdulMujeeb S, Hussain S, Chaus A. Singing the “Hole” Song - Pulsating Right Jugular Vein and Liver Due to a Severe Gerbode Defect. Clin Image Case Rep J. 2021; 3(2): 140.