Author + information
- Received January 24, 2013
- Accepted February 19, 2013
- Published online July 16, 2013.
- Frederic Poulin, MD, MSc,
- Eric M. Horlick, MDCM,
- Tirone David, MD,
- Anna Woo, MD, SM and
- Paaladinesh Thavendiranathan, MD, MSc
A 75-year-old woman with symptomatic mitral stenosis due to severe dystrophic calcification of the mitral annulus (A, arrowheads) underwent resection of the calcium bar with reconstruction of the base of the heart from the lateral to the medial fibrous trigone and ventricular septum using CorMatrix patches (Alpharetta, Georgia) and mitral valve replacement with a Hancock II bioprosthesis. Post-operatively, the patient developed biventricular failure and a loud murmur. A transesophageal echocardiogram (TEE) demonstrated a large left ventricle to right atrial communication measuring 7 × 11 mm (B, C [∗], Online Videos 1 and 2) due to dehiscence of the CorMatrix patch (D, Online Video 3). Due to the complexity of the shunt, 3-dimensional TEE guidance was used (E, Online Video 4) to close the defect percutaneously using a 14-mm Amplatzer VSD occluder (F to H, arrows, Online Videos 5, 6, and 7) with trivial residual shunt (H) and significant clinical improvement. We report the first case of 3-dimensional TEE-guided closure of a Gerbode shunt.
AV = aortic valve; IVS = interventricular septum; LA = left atrium; LAA = left atrial appendage; LV = left ventricle; RA = right atrium; TV = tricuspid valve.
Dr. Horlick receives fellowship support from and serves as a consultant and proctor for St. Jude Medical. Dr. David serves as a consultant for Medtronic and CorMatrix. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received January 24, 2013.
- Accepted February 19, 2013.
- 2013 American College of Cardiology Foundation