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Area of Science:

  • Cardiology
  • Infectious Diseases
  • Cardiac Surgery

Background:

  • Gerbode defect is a rare abnormal communication between the left ventricle and right atrium, often a complication of aortic infective endocarditis.
  • Group B Streptococcus (GBS) is an uncommon cause of infective endocarditis, known for its destructive effect on heart valves.
  • Acute fistulation in Gerbode defect is life-threatening, necessitating urgent surgical repair, but diagnosis can be challenging.

Purpose of the Study:

  • To describe a rare case of Gerbode defect resulting from Group B Streptococcus infective endocarditis.
  • To discuss the diagnostic and management challenges associated with this rare cardiac defect and infection.

Main Methods:

  • A 60-year-old male with uncontrolled diabetes presented with symptoms of infective endocarditis and cerebral embolisms.
  • Initial transthoracic echocardiography showed aortic regurgitation and vegetation, but no clear fistula.
  • Transesophageal echocardiogram confirmed aortic valve cusp detachment and identified the left ventricle-to-right atrium fistula (Gerbode defect) via Color Doppler.

Main Results:

  • The patient was diagnosed with Group B Streptococcus infective endocarditis with a Gerbode defect.
  • Urgent surgical intervention included aortic valve replacement, defect closure, and left ventricular outflow tract repair.
  • The patient was discharged without complications following successful treatment.

Conclusions:

  • Successful surgical treatment of an unusual active infective endocarditis and Gerbode defect caused by GBS was achieved.
  • Accurate and timely diagnosis through careful preoperative echocardiographic evaluation is crucial for successful repair of such rare cardiac defects.