Two attempts at transcatheter device closure of an acquired Gerbode defect following mitral valve replacement: A case report

Background A Gerbode defect, an abnormal communication between the left ventricle and right atrium, is acquired or congenital. A significant Gerbode defect may lead to symptomatic heart failure, requiring closure through surgery or intervention. Case summary We present a case of an acquired Gerbode defect in a 47-year-old woman with rheumatic heart disease who underwent a second mitral valve replacement. Postoperatively, heart failure was observed, which was attributed to severe tricuspid valve regurgitation. Subsequently, transthoracic and transoesophageal echocardiography and cardiac magnetic resonance imaging were used to establish a definitive diagnosis. The patient was successfully treated with percutaneous device closure, resulting in complete resolution of her heart failure. Discussion Gerbode defects can occur following cardiac surgery and are frequently misdiagnosed as tricuspid regurgitation or pulmonary hypertension. Transcatheter device closure may be a viable treatment option for patients at high risk of reoperation. However, it should be performed at a specialised centre with expertise in cardiac intervention.