Recurrence of Gerbode Defect despite Surgical Repair in a Patient with Bacterial Endocarditis

Gerbode defect refers to an abnormal communication of the left ventricle (LV) with the right atrium (RA), causing a severe left-to-right shunt. Symptoms of gerbode defect depend on the degree of communication between LV and RA. This defect can be congenital or acquired. Some etiologies of acquired gerbode defect include cardiac trauma, myocardial ischemia, a complication of prior cardiac surgery, or bacterial endocarditis. Regardless of the etiology, surgical intervention involving the closure of the defect is the definitive treatment of this rare anatomical anomaly. We present the case of a young man with an acquired gerbode defect as a complication of bacterial endocarditis for which he underwent surgical correction. He later had a recurrence and worsening of left-to-right shunt via the gerbode defect a few days after the first surgery, requiring another surgical intervention. To our knowledge, recurrence of this defect after a surgical repair has so far not been reported in the literature. Therefore, we conclude that patients presenting with symptoms of severe right heart failure in whom prior surgical repair of the gerbode defect is performed should prompt clinicians to rule out recurrence of this defect.