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Related Experiment Videos

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

Tuncay Taskesen1, Andrew Fred Prouse, Steven Lewis Goldberg

  • 1Division of Cardiology, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA, 98104, USA, taskesentuncay@gmail.com.

The International Journal of Cardiovascular Imaging
|February 15, 2015
PubMed
Summary

Acquired Gerbode defects (left ventricle to right atrium shunts) are increasingly reported due to cardiac procedures. Advanced imaging and less invasive treatments like percutaneous closure are improving outcomes.

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Medical Imaging

Background:

  • Acquired left ventricle to right atrium (LV-RA) shunts, known as Gerbode defects, are rare intracardiac shunts.
  • Historically congenital, acquired Gerbode defects are increasingly linked to invasive cardiac procedures, endocarditis, trauma, and myocardial infarction.
  • Rising numbers of invasive cardiovascular interventions contribute to the increased incidence of acquired Gerbode defects.

Purpose of the Study:

  • To review the etiologic, diagnostic, and treatment evolution of acquired LV-RA shunts over the past two decades.
  • To highlight advancements in cardiac imaging and therapeutic interventions for Gerbode defects.

Main Methods:

  • Review of recent literature on acquired LV-RA shunts.
  • Discussion of advanced cardiac imaging modalities including cardiac CT, MRI, and Real-time 3D echocardiography.

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  • Analysis of surgical and percutaneous treatment strategies.

    • Main Results:

    • Advanced imaging techniques like Real-time 3D echocardiography offer definitive diagnosis and detailed anatomical characterization of Gerbode defects.
    • While surgical repair remains standard, percutaneous catheter-based closure has emerged as a successful, less invasive treatment option for select patients.
    • The increased frequency of acquired Gerbode defects has spurred the development of improved diagnostic tools and less invasive therapeutic approaches.

    Conclusions:

    • Acquired Gerbode defects necessitate a thorough understanding of their changing etiology.
    • Real-time 3D echocardiography plays a crucial role in both diagnosing and guiding treatment for these shunts.
    • Less invasive treatment options, particularly percutaneous closure, represent significant progress in managing acquired LV-RA shunts.