Surgical Tricuspid Valve Repair Resulting in Acquired Gerbode Defect: A Rare and Challenging Case

Acquired Gerbode defect is a complication of cardiac surgery. Diagnostic challenges arise because of frequent mischaracterization as severe tricuspid regurgitation on imaging, often delaying definitive management.

After undergoing surgical tricuspid valve repair, a patient developed an acquired Gerbode defect located in the membranous septum beneath the noncoronary cusp of the aortic valve. The defect remained undetected for over 3 years owing to misinterpretation of echocardiographic findings as severe tricuspid regurgitation. Comprehensive transesophageal echocardiography enabled accurate diagnosis and anatomical localization.

The defect was successfully closed percutaneously under transesophageal echocardiographic and fluoroscopic guidance using a 6-mm Amplatzer atrial septal defect occluder device. The procedure resulted in complete closure of the shunt, with no residual defect or complications.

This case highlights the importance of advanced imaging for the diagnosis of elusive acquired Gerbode defects and demonstrates that percutaneous device closure is a safe and effective therapeutic option for this uncommon postsurgical complication.