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You are here: Contents > 2015 > Volume 24 Number 3 May 2015 > AORTIC VALVE DISEASE > Gerbode Defect as a Result of Fungal Aortic Valve Endocarditis

Gerbode Defect as a Result of Fungal Aortic Valve Endocarditis

Chetan Pasrija1, Isa Mohammed1, Inna Shats2, Susie Hong-Zohlman2, Junewai Reoma1, Michael A. Mazzeffi3, Keshava Rajagopal1

Divisions of 1Cardiac Surgery, 2Cardiovascular Medicine and 3Cardiothoracic Anesthesiology, University of Maryland School of Medicine and Medical Center, Baltimore, MD, USA

A 63-year-old male patient with HIV disease presented with dyspnea and complete heart block, and was found to have aortic valve (AV) endocarditis secondary to Candida parapsilosis infection. Echocardiography demonstrated AV endocarditis and possible aortic root versus subannular abscess with moderate AV regurgitation (AR), a ventricular septal defect (VSD) and possible left ventricular to right atrial shunt (Gerbode defect). Large AV vegetations, subannular abscess with an acquired membranous VSD, Gerbode defect, and tricuspid annular abscess at the insertion of septal leaflet were noted intraoperatively. The patient underwent AV replacement with a stented bioprosthesis, two-sided VSD patch closure, and tricuspid valve (TV) repair with an annuloplasty ring. The left-sided patch closed the VSD and facilitated AV replacement, while the right-sided patch facilitated the TV repair.

Video 1: Long-axis view of left ventricular outflow tract (LVOT), demonstrating the AR jet and VSD.

Video 2: Preoperative four-chamber view demonstrating systolic flow into the RV and RA.

Video 3: Preoperative short-axis view of the AV, showing vegetations on the aortic valve, along with abscess at the right non-coronary commissure and related membranous VSD.

Video 4: Postoperative four-chamber view, demonstrating the absence of intracardiac shunt

Video 5: Postoperative short-axis view of the AV, demonstrating an intact prosthetic AV, with no VSD.

The Journal of Heart Valve Disease 2015;24:292-294

Gerbode Defect as a Result of Fungal Aortic Valve Endocarditis

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