Percutaneous closure of acquired Gerbode type I defect in adults: summary of a consecutive series of 7 cases

Gerbode defect (GD) is a rare anomaly: a left ventricle-to-right atrium shunt. Due to its infrequency, there are no treatment standards.

We aimed to assess the feasibility, efficacy, and complications of transcatheter closure of acquired Gerbode defects in a consecutive series of adult patients.

The single-center, prospective registry included all consecutive patients with iatrogenic GD treated via a transvenous approach using a steerable sheath and a telescopic system under 3D-RT TEE guidance between 2003 and 2025. Baseline, procedural, and follow-up data were analyzed.

We included 7 patients (3/7, 43% male) with a median age of 54.7 years (30-85 years). All patients presented with symptomatic right-sided heart failure (NYHA III, n = 6; NYHA IV, n = 1) and right ventricular dilatation on echocardiography. Devices used were the Amplatzer Membranous VSD, with a median central diameter of 6 mm (range: 6-8), and the ADO II device. Procedural success (device deployment and effective occlusion) was achieved in 5/7 patients (57%). Median pulmonary pressure fell from a baseline of 41 mm Hg (34-70 mm Hg) to 27 mm Hg (23-39 mm Hg) post-procedurally (p = 0.002).

In this small series, transvenous closure of an acquired Gerbode defect using a steerable sheath and telescopic system under 3D-RT transesophageal echocardiography (TEE) was feasible in 5/7 patients. Larger studies with longer follow-up are needed to confirm the safety and efficacy of this approach.