Gerbode Defect with Staphylococcus lugdunensis Native Tricuspid Valve Infective Endocarditis

2012 ◽  
Vol 27 (3) ◽  
pp. 316-320 ◽  
Author(s):  
Robert J. Carpenter ◽  
Gregory D. Price ◽  
Gilbert E. Boswell ◽  
Keshav R. Nayak ◽  
Alfredo R. Ramirez
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Staphylococcus Lugdunensis ◽  
Gerbode Defect

Tricuspid Valve Excision Complicated by Postoperative Gerbode Defect Following Recurrent Infective Endocarditis: A Case Report

2020 ◽  
pp. 108925322095226
Author(s):  
Jasdeep S. Dhaliwal ◽  
Michael J. Wadle ◽  
Rajasekhar Malyala ◽  
Sanjay Dwarakanath ◽  
Kevin W. Hatton
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Surgical Intervention ◽  
Critically Ill Patient ◽  
Opioid Epidemic ◽  
Intravenous Drug Use ◽  
Recurrent Infections ◽  
Number Of Patients ◽  
Gerbode Defect ◽  
Tricuspid Valve Endocarditis

Tricuspid valve infective endocarditis is an increasingly common sequela of the opioid epidemic. While often managed medically, certain subsets of patients will require surgical intervention, including repair, replacement, and possibly even excision. Historically, simple valvectomy was performed in instances of recidivism and reinfection; however, reoperation and replacement has become the preferred treatment in the current era. Given the increasing incidence of intravenous drug use and the increase in the number of patients presenting with recurrent infections, simple valvectomy has regained favor in recent years. In this article, we present the management of a critically ill patient with recurrent tricuspid valve endocarditis who underwent tricuspid valvectomy that was complicated by a left ventricle to right atrium fistula and discuss some of the most important perioperative issues and complications for patients who undergo tricuspid valvectomy.

scholarly journals Infective Endocarditis Caused by Neisseria elongata on a Native Tricuspid Valve and Confirmed by DNA Sequencing

2014 ◽  
Vol 41 (2) ◽  
pp. 227-230 ◽  
Author(s):  
Yeon Pyo Yoo ◽  
Ki-Woon Kang ◽  
Hyeon Soo Yoon ◽  
Seungmin Yoo ◽  
Myung-Shin Lee
Keyword(s):  
Infective Endocarditis ◽  
Antibiotic Therapy ◽  
Dna Sequencing ◽  
Tricuspid Valve ◽  
Unusual Case ◽  
Blood Cultures ◽  
Gram Negative ◽  
Dental Procedures ◽  
Oral Bacterium ◽  
Gerbode Defect

Neisseria elongata, a common oral bacterium, has been recognized as a cause of infections such as infective endocarditis, septicemia, and osteomyelitis. Neisseria-induced infective endocarditis, although infrequently reported, typically arises after dental procedures. Without antibiotic therapy, its complications can be severe. We report the case of a 27-year-old man who presented with fever, severe dyspnea, and a leg abscess from cellulitis. An echocardiogram showed a vegetation-like echogenic structure on the septal leaflet of the patient's native tricuspid valve, and an insignificant Gerbode defect. Three blood cultures grew gram-negative, antibiotic-susceptible coccobacilli that were confirmed to be N. elongata. Subsequent DNA sequencing conclusively isolated N. elongata subsp nitroreducens as the organism responsible for the infective endocarditis. The patient recovered after 21 days of antibiotic therapy. In addition to the patient's unusual case, we discuss the nature and isolation of N. elongata and its subspecies.

scholarly journals Congenital Gerbode Defects Complicated by Infective Endocarditis: 2 Case Reports

2021 ◽  
Vol 07 (07) ◽  
Author(s):  
H. Bel Houssine ◽  
Keyword(s):  
Infective Endocarditis ◽  
Transesophageal Echocardiography ◽  
Tricuspid Valve ◽  
Right Atrium ◽  
Case Reports ◽  
Congenital Defects ◽  
Excellent Outcome ◽  
Surgical Closure ◽  
Valve Tissue ◽  
Gerbode Defect

Gerbode defect is a rare shunt between the left ventricule and right atrium. The etiology is typically congenital. The infravalvular type is the most common. The congenital defects are believed to close by forming an aneurysmal pouch through incorporating adjacent tricuspid valve tissue. Endocarditis is responsible for this shunt by re-opening the defect. Diagnosis is based on the transesophageal echocardiography. Surgical closure demonstrated an excellent outcome. We present 2 cases with this uncommon congenital shunt complicated by infective endocarditis and septic embolism.

scholarly journals The Gerbode defect: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Nicholas Sunderland ◽  
Ahmed El-Medany ◽  
Justin Temporal ◽  
Laura Pannell ◽  
Gemina Doolub ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Aortic Valve ◽  
Case Series ◽  
Decompensated Heart Failure ◽  
Left Ventricular ◽  
Cardiac Complications ◽  
Low Grade ◽  
Care Needs ◽  
Intravenous Antibiotics ◽  
Gerbode Defect

Abstract Background  The Gerbode defect is a rare abnormal communication between the left ventricle (LV) and right atrium (RA). The lesion is either congenital or acquired. Acquired defects are largely iatrogenic or infective in origin. We present two cases of acquired Gerbode defects with similar clinical presentations but very different outcomes. Case summaries Patient 1 A 64-year-old male presented with features of decompensated cardiac failure and a low-grade temperature. Dehiscence of a recently implanted bioprosthetic aortic valve and high-velocity LV to RA jet (Gerbode defect) was found on echocardiography. Blood cultures grew Staphylococcus warneri and the diagnosis of infective endocarditis was established. The patient was treated with intravenous antibiotics and the aortic valve and Gerbode defect were successfully surgically repaired. Patient 2 An 81-year-old male presented after being found on the floor at home. On admission, he was clinically septic with evidence of decompensated heart failure. No clear infective focus was initially found. Transthoracic echocardiography revealed severe left ventricular impairment, with a normal bioprosthetic aortic valve. He was treated with intravenous antibiotics, but later deteriorated with evidence of embolic phenomena. Repeat echocardiography revealed a complex infective aortic root lesion with bioprosthetic valve dehiscence and flow demonstrated from the LV to RA. Unfortunately, the patient succumbed to the infection and cardiac complications. Discussion  The Gerbode defect is a rare but important complication of infective endocarditis and valve surgery. Care needs to be taken to assess for Gerbode defect shunts on echocardiogram, especially in the context of previous cardiac surgery.

scholarly journals 695. Infective endocarditis in people who inject drugs (PWID) at UK Medical Center

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S399-S400
Author(s):  
Evelyn Villacorta Cari ◽  
John T Henderson ◽  
Donna R Burgess ◽  
J Zachary Porterfield ◽  
Nicole Leedy ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Bacterial Infections ◽  
Medical Center ◽  
Cross Sectional Study ◽  
Addiction Medicine ◽  
University Of Kentucky ◽  
Cross Sectional ◽  
Health Crisis ◽  
Gram Negative

Abstract Background The Intravenous Drug Use (IVDU) epidemic has been developing into a public health crisis in the last twenty years. As a result, the incidence of severe bacterial infections such as infective endocarditis (IE) has been rising dramatically. Methods Cross-sectional study, we reviewed records of all admissions to University of Kentucky hospitals with IVDU associated ICD9/10 codes who received an Infectious Diseases consult during 2018 and focused on the cases with a diagnosis of IE. We describe associated epidemiologic, clinical, and microbiological features Results We include 391 patients in this cohort, among those 157 patients were for IE. Patients had a median age of 34 years old (range: 20 - 62); 81 (51.5%) were female, and five (6.1%) were pregnant and 153 (97.4%) identified as white. A previous episode of infective endocarditis was reported in 55 (35%) cases. The most common illicit substances used were heroin 68 (43.3%) and methamphetamine 65 (41.45%). Tobacco abuse was reported in 134 (86.4%) cases. Fever reported in 93 (59.8%) cases, shortness of air in 43 (28.0%) cases, and chest pain in 44 (28.6%) cases were the most common symptoms. Hepatitis C antibody was positive in 115/149 (73.2%) and 3/143 (1.9%) were HIV positive. Right-sided IE was more frequent, the tricuspid valve was involved in 94 (59.8%) patients. Gram-positive pathogens were isolated in 139 (88.5%) patients, Staphylococcus aureus was isolated in 102 (64.9%) patients, of which 67 (65.7%) were methicillin resistant. Gram-negative pathogens were isolated in 18 (11.2%) patients. Eighty-eight (56.4%) patients had an addiction medicine consult during their admission, (22.9%) patients left against medical advice and 20 (12.7%) patients needed to be readmitted within 30 days after discharge. Overall mortality was 12.7% and was significantly associated with infection by gram-negative pathogens (RR: 2.5; CI 95% 1.05 – 6.25, p=0.037). Conclusion Infectious endocarditis is a frequent complication in PWID which carries a high risk of mortality and often involves the tricuspid valve. The most common pathogen isolated was S. aureus, isolation of gram-negative pathogens was associated with increased mortality. Disclosures All Authors: No reported disclosures

Isolated tricuspid valve endocarditis in immunocompetent juvenile patients: a series of three cases

2021 ◽  
Vol 14 (8) ◽  
pp. e244312
Author(s):  
Atanu Chandra ◽  
Shrestha Ghosh ◽  
Uddalak Chakraborty ◽  
Debojyoti Ray
Keyword(s):  
Risk Factors ◽  
Infective Endocarditis ◽  
Tricuspid Valve ◽  
Age Groups ◽  
Case Series ◽  
Venous Catheter ◽  
Diagnostic Challenge ◽  
Native Valve ◽  
Younger Age ◽  
High Index Of Suspicion

Right-sided native valve infective endocarditis is common in patients with congenital or valvular heart disease, intracardiac device, central venous catheter and intravenous drug abuse, usually manifesting in adulthood. However, in the absence of predisposing risk factors and in younger age groups, this disease may pose a diagnostic challenge. We report a case series of three juvenile patients with isolated tricuspid valve infective endocarditis without any risk factors and paucity of cardiovascular findings in two of them, in an attempt to highlight the importance of maintaining a high index of suspicion to arrive a timely diagnosis.

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