Echocardiographic diagnosis of left ventricular-right atrial communication

Gerbode defect: A comprehensive review of its history, anatomy, embryology, pathophysiology, diagnosis, and treatment

The purpose of this paper is to survey the literature on Gerbode defect and provide an overview of its history, anatomy, development, pathophysiology, diagnosis, and treatment options. The available literature on this topic, including case reports, was thoroughly reviewed. Gerbode defect is defined as abnormal shunting between the left ventricle and right atrium resulting from either a congenital defect or prior cardiac insults. The pathophysiology underlying the development of Gerbode defect is a disease process that injures the atrioventricular septum and leads to the abnormal shunting of blood. Although the most prevalent cause of Gerbode defect has historically been congenital, an increasing trend towards acquired cases has recently been reported owing to improved diagnostic capabilities and a greater number of invasive cardiac procedures. In conclusion, Gerbode defect is an increasingly recognized condition that warrants further study.

The spectrum of left ventricular-right atrial communications in the adult: essentials of echocardiographic assessment

Left ventricular-right atrial communication may be a congenital defect or can result from trauma, endocarditis, or valve replacement. Traditionally the preoperative diagnosis of this entity was made during cardiac catheterization, but recent advances in echocardiography, particularly color Doppler imaging, have greatly facilitated the noninvasive diagnosis of left ventricular-right atrial communication. We present four cases of left ventricular-right atrial communication, each identified by two-dimensional and color Doppler imaging. One case is a congenital defect, two were identified years after cardiac surgery, and one presents as an unusual complication of myocardial infarction. Optimal views for identifying this defect are discussed along with clues to quantifying its hemodynamic significance.

An echocardiographic study of perimembranous ventricular septal defect with left ventricular to right atrial shunting

Twenty nine patients with isolated perimembranous ventricular septal defects were investigated by M mode, cross sectional, and pulsed Doppler echocardiography. Tricuspid valve anomalies were present in all six patients with a left ventricular-right atrial shunt but in only six (26%) of 23 patients who had interventricular shunts only. Systolic flutter of the tricuspid valve was shown in five (83%) of the six patients with a ventriculoatrial shunt but not in the other patients. Systolic turbulence in both the right ventricle and right atrium was detected by Doppler echocardiography only in patients with ventriculoatrial shunting. A perimembranous ventricular septal defect with left ventricular to right atrial shunt can be diagnosed by its combined M mode, cross sectional, and pulsed Doppler echocardiographic features.