{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T11:23:58Z","timestamp":1770549838846,"version":"3.49.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Gerbode defect is an unusual abnormal communication between the left ventricle and the right atrium and is a serious complication of aortic infective endocarditis. Group B <jats:italic>Streptococcus<\/jats:italic> is an uncommon cause of infective endocarditis and has a markedly destructive effect on valvular tissue. Acute fistulation between the left ventricle and the right atrium associated with this form of infective endocarditis is a life-threatening, aggressive complication that often requires urgent surgical intervention. However, the identification of actual communication is often extremely difficult. Herein, we describe an unusual case of Gerbode defect resulting from Group B <jats:italic>Streptococcus<\/jats:italic> infective endocarditis and discuss the issues surrounding such a rare cardiac defect and such an infection.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 60-year-old man with underlying uncontrolled diabetes mellitus underwent endoscopic retrograde biliary drainage for acute cholangitis. On the 10th postoperative day, the patient developed multiple acute cerebral embolisms. Transthoracic echocardiography demonstrated severe aortic regurgitation and a large mobile vegetation near the tricuspid annulus. No obvious fistula between the left ventricle and the right atrium could be demonstrated. The blood culture examination was positive for Group B <jats:italic>Streptococcus<\/jats:italic>. The patient was diagnosed with Group B <jats:italic>Streptococcus<\/jats:italic> infective endocarditis, and antibiotic therapy was initiated. Transesophageal echocardiogram performed after referral to our hospital confirmed detachment of the right coronary cusp of the aortic valve from the annulus and an abnormal cavity immediately below the right coronary cusp. Color Doppler imaging finally revealed systolic blood flows from the left ventricle into the right atrium through the cavity. Therefore, we diagnosed the patient with Gerbode defect resulting from Group B <jats:italic>Streptococcus<\/jats:italic> infective endocarditis. In addition to aortic valve replacement, defect closure and left ventricular outflow tract repair were successfully performed urgently for severely complicated and uncommon infective endocarditis. The patient was uneventfully discharged without any complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We reported successful surgical treatment of unusual active IE and Gerbode defect caused by GBS. Careful preoperative echocardiographic work-up is imperative for accurate early diagnosis and successful repair.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-01943-5","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T03:40:29Z","timestamp":1718768429000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gerbode defect resulting from Group B Streptococcus infective endocarditis: a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-4690-8308","authenticated-orcid":false,"given":"Kazuki","family":"Hisatomi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuya","family":"Miyanaga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Miura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoyuki","family":"Eishi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"issue":"1","key":"1943_CR1","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s12879-021-06997-6","volume":"22","author":"T Oravec","year":"2022","unstructured":"Oravec T, Oravec SA, Leigh J, et al. Streptococcus agalactiae infective endocarditis in Canada: a multicenter retrospective nested case control analysis. BMC Infect Dis. 2022;22(1):18.","journal-title":"BMC Infect Dis"},{"issue":"3","key":"1943_CR2","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1097\/00000658-195809000-00012","volume":"148","author":"F Gerbode","year":"1958","unstructured":"Gerbode F, Hultgren H, Melrose D, Osborn J. Syndrome of left ventricular-right atrial shunt; successful surgical repair of defect in five cases, with observation of bradycardia on closure. Ann Surg. 1958;148(3):433\u201346.","journal-title":"Ann Surg"},{"key":"1943_CR3","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1186\/s13019-015-0320-z","volume":"10","author":"E Prifti","year":"2015","unstructured":"Prifti E, Ademaj F, Baboci A, Demiraj A. Acquired Gerbode defect following endocarditis of the tricuspid valve: a case report and literature review. J Cardiothorac Surg. 2015;10:115.","journal-title":"J Cardiothorac Surg"},{"issue":"5","key":"1943_CR4","doi-asserted-by":"publisher","first-page":"844","DOI":"10.1016\/S1010-7940(03)00048-4","volume":"23","author":"N Alphonso","year":"2003","unstructured":"Alphonso N, Dhital K, Chambers J, Shabbo F. Gerbode\u2019s defect resulting from infective endocarditis. Eur J Cardiothorac Surg. 2003;23(5):844\u20136.","journal-title":"Eur J Cardiothorac Surg"},{"issue":"2","key":"1943_CR5","doi-asserted-by":"publisher","first-page":"ytaa548","DOI":"10.1093\/ehjcr\/ytaa548","volume":"5","author":"N Sunderland","year":"2021","unstructured":"Sunderland N, El-Medany A, Temporal J, et al. The Gerbode defect: a case series. Eur Heart J Case Rep. 2021;5(2):ytaa548.","journal-title":"Eur Heart J Case Rep."},{"issue":"1","key":"1943_CR6","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1016\/S0894-7317(05)80368-2","volume":"8","author":"D Elian","year":"1995","unstructured":"Elian D, Di Segni E, Kaplinsky E, Mohr R, Vered Z. Acquired left ventricular-right atrial communication caused by infective endocarditis detected by transesophageal echocardiography: case report and review of the literature. J Am Soc Echocardiogr. 1995;8(1):108\u201310.","journal-title":"J Am Soc Echocardiogr"},{"issue":"3","key":"1943_CR7","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1093\/icvts\/ivz284","volume":"30","author":"T Uchida","year":"2020","unstructured":"Uchida T, Kuroda Y, Kobayashi K, Sadahiro M. Surgical treatment for left ventricular-aortic discontinuity and Gerbode defect with endocarditis. Interact Cardiovasc Thorac Surg. 2020;30(3):439\u201342.","journal-title":"Interact Cardiovasc Thorac Surg"},{"issue":"5","key":"1943_CR8","doi-asserted-by":"publisher","first-page":"ofaa120","DOI":"10.1093\/ofid\/ofaa120","volume":"7","author":"N Fern\u00e1ndez Hidalgo","year":"2020","unstructured":"Fern\u00e1ndez Hidalgo N, Gharamti AA, Aznar ML, et al. Beta-hemolytic Streptococcal infective endocarditis: characteristics and outcomes from a large, multinational cohort. Open Forum Infect Dis. 2020;7(5):ofaa120.","journal-title":"Open Forum Infect Dis"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01943-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-024-01943-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01943-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T19:08:05Z","timestamp":1718824085000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-024-01943-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,19]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1943"],"URL":"https:\/\/doi.org\/10.1186\/s40792-024-01943-5","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,19]]},"assertion":[{"value":"16 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The patient provided informed written consent for the publication of this case report and accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"151"}}