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Transcatheter Closure of a Congenital Gerbode Defect in a Child
Ana Lucia Madrid-Marin1, Ernesto L Vallejo-Mondragón2, Antonio J Madrid Pinilla2
1Pontificia Universidad Javeriana, Bogotá, Colombia.
Insights
Transcatheter closure is a safe and effective treatment for pediatric Gerbode defects. This approach is particularly useful when open-heart surgery is not feasible, offering a viable alternative for congenital heart repair.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Congenital Heart Disease
Background:
- Gerbode defect is a rare left ventricular-to-right atrial communication, accounting for less than 1% of congenital heart defects.
- Percutaneous closure is an established surgical alternative, but pediatric data are limited.
Background:
The Gerbode defect is a rare left ventricular-to-right atrial communication (<1% of congenital heart defects). Percutaneous closure is a well-established alternative to surgery, although pediatric evidence remains limited.
Case Summary:
A 12-year-old girl with a neonatal-onset holosystolic murmur was lost to follow-up at age 3 after a canceled surgical repair; she returned to care 9 years later after remaining asymptomatic. Transesophageal echocardiography confirmed a 4-mm type II congenital Gerbode defect-a perimembranous ventricular septal defect with anomalous tricuspid chordal insertion causing indirect left-to-right shunting. She successfully underwent transcatheter closure using a 4-mm muscular ventricular septal defect occluder.
Discussion:
This case demonstrates safety and feasibility of off-label occluder use in pediatric type II Gerbode defects, particularly when cultural beliefs preclude open-heart surgery.
Take-Home Messages:
Transcatheter closure is safe and effective in selected pediatric Gerbode defects. Detailed echocardiographic assessment is essential for characterization, procedural guidance, and misdiagnosis avoidance.
