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Updated: May 13, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Transcatheter closure of acquired left ventricle to right atrium shunts
Juha Sinisalo1, Narayanswami Sreeram, Shakeel A Qureshi
1Department of Medicine, Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland.
Insights
Transcatheter closure effectively treats acquired Gerbode defects (left ventricle to right atrium shunts) in patients with prior heart surgery. This minimally invasive approach resolves heart failure symptoms, offering a potential alternative to surgical repair.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Acquired Gerbode defects, characterized as left ventricle to right atrium shunts, can develop after cardiac surgery.
- Patients may present with persistent or delayed-onset heart failure symptoms following interventions like VSD closure or aortic valve replacement.
Observation:
- Four patients (ages 8-75) with prior cardiac surgeries presented with symptoms attributed to acquired Gerbode defects.
- Diagnosis was confirmed using advanced imaging (echocardiography, MRI) and cardiac catheterization.
Findings:
- Transcatheter device closure was technically successful in all four patients.
- All patients experienced resolution of heart failure symptoms post-procedure.
- One patient developed complete heart block requiring pacemaker implantation.
Implications:
- Transcatheter closure represents a safe and effective treatment option for acquired Gerbode defects.
- This minimally invasive technique may serve as a viable alternative to conventional surgical repair.
- Further research can explore long-term outcomes and expand indications for transcatheter closure.
Abstract:
We describe transcatheter closure of an acquired Gerbode defect (left ventricle to right atrium shunt) in four patients, ranging in age from 8 to 75 years. All of them had undergone previous surgery (VSD closure in 3, aortic valve replacement in 1), and either had persistent symptoms of heart failure, or developed new symptoms several months or years later. The diagnosis was made by one of several imaging modalities (transthoracic or transesophageal echocardiography, or MRI), and confirmed at cardiac catheterization. Device closure using a variety of devices was successful in all, with resolution of symptoms. One patient developed complete heart block, requiring permanent pacemaker implantation. Transcatheter closure is effective, and may replace surgery in the management of these defects.
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