Case report: acquired Gerbode defect and ventricular septal defect in a patient with native valve infective endocarditis

Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality. Complications, such as abscess formation, fistulae, and intracardiac shunts, including Gerbode defects, are rare but critical to recognize.

A 67-year-old male with severe aortic stenosis and a bicuspid aortic valve presented with palpitations, fevers, and vomiting. After progression of his symptoms and the development of cardiogenic shock, investigations revealed Streptococcus mitis IE of the aortic and tricuspid valves, complicated by aortic root abscess, complete heart block, and a Gerbode defect with a ventricular septal defect. Diagnosis was confirmed with transoesophageal echocardiography, and urgent surgical intervention included valve replacement, tricuspid valve repair, and closure of the defects. The patient was discharged with a 6-week course of intravenous antibiotics and multidisciplinary follow-up.

This case highlights the diagnostic and therapeutic challenges of IE, underscoring the importance of imaging and early surgical intervention. Gerbode defects, though rare, are increasingly recognized as severe complications of IE, necessitating prompt management.