Gerbode defect presenting as an atypical tricuspid regurgitation jet: recognizing the unrecognized

Moojun Kim; Geunhee Park; Joongmin Kim; Hyeongsoo Kim; Ji-Yong Jang; HanCheol Lee; Jong-Kwan Park; Seungjin Oh; Se-Jung Yoon

doi:10.1186/s44348-026-00105-5

November 9, 2026Journal of Cardiovascular ImagingOpen Access

Gerbode defect presenting as an atypical tricuspid regurgitation jet: recognizing the unrecognized

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Key Points

Detail the clinical and imaging characteristics of a rare congenital left ventricle-to-right atrium shunt that mimicked severe tricuspid regurgitation and pulmonary hypertension.
Evaluated an asymptomatic 52-year-old female referred for cardiomegaly detected during routine screening.
Conducted transthoracic echocardiography, transesophageal echocardiography, and cardiac computed tomography to characterize chamber dimensions, hemodynamics, and shunt anatomy.
Initial transthoracic echocardiography showed a dilated right atrium and an abnormal jet calculating a right ventricular systolic pressure of 98 mmHg, despite normal right ventricular size and normal left ventricular dimensions.
Transesophageal echocardiography and cardiac computed tomography identified an atypical jet traversing the perimembranous septum directly from the left ventricle into the right atrium, consistent with a direct type Gerbode defect.
A separate, true mild tricuspid regurgitation jet demonstrated a normal right ventricular systolic pressure of 20 mmHg, with a normal right ventricular outflow tract velocity–time integral of 14 cm and a Qp/Qs ratio of 0.9.

Structured PICO

P

Population

52-year-old asymptomatic female patient (n=1) referred for cardiomegaly detected on routine health screening, with no significant medical or surgical history, diagnosed with a congenital direct type (supravalvular) Gerbode defect in the Republic of Korea.

I

Intervention

Multimodality cardiac imaging evaluation including transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and coronary computed tomography (CT)

O

Outcome

Definitive diagnosis of a congenital direct type supravalvular Gerbode defect (left ventricle-to-right atrium shunt) mimicking a severe tricuspid regurgitation jet or ventricular septal defect

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Implication

Careful evaluation of jet origin and pathway using color Doppler echocardiography and cardiac CT is essential to distinguish a congenital direct Gerbode defect from severe tricuspid regurgitation or ventricular septal defect, especially when an unexpectedly high estimated right ventricular systolic pressure does not match clinical or right ventricular structural findings.

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Cite This Study

Kim et al. (2026) studied this question.

synapsesocial.com/papers/6af1d8a6f9a8addd138b1cfa https://doi.org/10.1186/s44348-026-00105-5

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Gerbode defect presenting as an atypical tricuspid regurgitation jet: recognizing the unrecognized

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Gerbode defect presenting as an atypical tricuspid regurgitation jet: recognizing the unrecognized

Key Points

Structured PICO

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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