"Holes-in-one": A case of concurrent windsock mitral valve, root abscess, and Gerbode defect

Echocardiography. 2020 Jun;37(6):935-938. doi: 10.1111/echo.14703. Epub 2020 May 19.


Infective endocarditis is a heterogeneous disease with a wide array of pathological lesions. We present a 55-year-old man with severe mitral and aortic regurgitation on transthoracic echocardiography. Transesophageal echocardiogram characterized the mechanisms detecting a windsock mitral valve perforation, aortic root abscess, and Gerbode ventricular septal defect, with the deep transgastric view showing all three pathologies concurrently. The etiologies of mitral valve perforation and Gerbode defects are discussed. Transesophageal echocardiography remains a critical imaging modality to diagnose and evaluate the extent of infective endocarditis with superior sensitivity to transthoracic echocardiography.

Keywords: Gerbode defect; aortic regurgitation; infective endocarditis; mitral regurgitation; transesophageal echocardiography.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abscess / complications
  • Abscess / diagnostic imaging
  • Aortic Valve / diagnostic imaging
  • Aortic Valve Insufficiency*
  • Echocardiography, Transesophageal
  • Endocarditis, Bacterial* / complications
  • Endocarditis, Bacterial* / diagnostic imaging
  • Heart Septal Defects, Ventricular* / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Mitral Valve / diagnostic imaging