Gerbode ventricular septal defects type I, II and III

Gerbode ventricular septal defects type I, II and III Though congenital left ventricle to right atrium connections have been described as early as 1838 at autopsy [1, cited in 2], the description by Frank Gerbode and colleagues was in 1958, in their surgical series [3]. They described three varieties of communications: Fusion of the septal leaflet of the tricuspid valve to the edges of the ventricular septal defect associated with a perforation of the leaflet. Shunt occurs from left ventricle directly into right atrium. A defect or cleft of tricuspid valve close to its point of attachment directly overlying the VSD. A combination of these two lesions. They also described the finding of bradycardia and rise in systemic blood pressure while closing the defect manually at surgery. This they mentioned, was similar to the Branham reflex described in case of a peripheral arteriovenous fistula [4]. The rise in blood pressure due to increase in systemic blood flow stimulates carotid sinus receptors and causes reflex vagally mediated bradycardia. Though the initial descriptions were of congenital defects, later the terminology has been expanded to include acquired LV-RA shunts as well. Possible reasons are invasive cardiac procedures, endocarditis, trauma and myocardial infarction [5]. Advanced cardiac imaging techniques like computed tomography, magnetic resonance imaging and real-time 3D echocardiography have been useful in definitive diagnosis and anatomic characterization of the...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs