Congenital Gerbode defect in an adult patient: report of an extremely rare case
Palabras clave:Gerbode Defect, congenital heart disease, structural cardiac pathology
Gerbode Defect (GD) is a rare congenital heart disease that mainly affects the upper portion of the membranous septum, generating a shunt between the left ventricle and the right atrium. Even though most cases are congenital, it has also been reported acquired cases due to cardiac surgery, infective endocarditis, acute ischemic heart disease, and invasive percutaneous procedures. The diagnostic workup includes the clinical evaluation and the echocardiographic study. Here, we present the case of a 43-year-old adult patient with an incidental finding of a congenital GD in the context of acute appendicitis. Imaging plays a role in the diagnostic workup of congenital diseases; in this case, it allowed us to identify more details and the decision- making for our patient.
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technique, there are more and more reports on percutaneous closure in patients with high surgical risk (5,8,9). The technical success of surgical repair is excellent, and it has low mortality rates (<3%); however, surgery in the context of acquired GD due to endocarditis or myocardial infarction could be associated with higher mortality (15-65%) (4,6).
In conclusion, despite the lack of comparative studies, patients with GD will require close clinical and echocardiographic follow-up in shorter intervals than for other septal defects. We have to bear in mind that the right atrium is the chamber with the lowest pressure, and having high pressure from the left ventricle, will cause enlargement and then increase pulmonary blood flow, which ends in pulmonary hypertension. Therefore, outpatient imaging with echocardiographic plays an important role in the close follow-up of patients with this rare condition.
All authors contributed equally to the idea, data collection, drafting and final approval of the manuscript.
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