Transcatheter Closure of a Congenital Gerbode Defect in a Child.

BACKGROUND

The Gerbode defect is a rare left ventricular-to-right atrial communication (<1% of congenital heart defects). Percutaneous closure is a well-established alternative to surgery, although pediatric evidence remains limited.

CASE SUMMARY: A 12-year-old girl with a neonatal-onset holosystolic murmur was lost to follow-up at age 3 after a canceled surgical repair; she returned to care 9 years later after remaining asymptomatic. Transesophageal echocardiography confirmed a 4-mm type II congenital Gerbode defect-a perimembranous ventricular septal defect with anomalous tricuspid chordal insertion causing indirect left-to-right shunting. She successfully underwent transcatheter closure using a 4-mm muscular ventricular septal defect occluder.

DISCUSSION: This case demonstrates safety and feasibility of off-label occluder use in pediatric type II Gerbode defects, particularly when cultural beliefs preclude open-heart surgery.

TAKE-HOME MESSAGES: Transcatheter closure is safe and effective in selected pediatric Gerbode defects. Detailed echocardiographic assessment is essential for characterization, procedural guidance, and misdiagnosis avoidance.