title: Snare vegetectomy for right-sided endocarditis.
abstract: BACKGROUND
  A middle-aged male developed right-sided endocarditis from an infection of an implantable cardiac defibrillator (ICD) system. Following percutaneous device and lead explantation, a very large pedunculated vegetation (19 mm × 14 mm) was found on the Eustachian valve. We decided to remove the vegetation percutaneously using a wire snare instead of open heart surgery.
  
  
  METHODS
  Real-time three-dimensional transesophageal echocardiography and fluoroscopy were used to guide the procedure. Access was from the right femoral vein. Using a triple-loop wire snare through a deflectable sheath, the vegetation was successfully removed in its entirety without complications.
  
  
  CONCLUSIONS
  Percutaneous snare vegetectomy is feasible and may be a viable option in place of open heart surgery in selected patients.
authors.affiliation: Department of Cardiology, National University Heart Centre, Singapore, Singapore.
authors.forename: Swee-Chong
authors.initials: SC
authors.lastname: Seow
authors.forename: Wei-Qin
authors.initials: WQ
authors.lastname: Lin
authors.forename: Raymond C C
authors.initials: RC
authors.lastname: Wong
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006328:Cardiac Catheterization; D017147:Defibrillators, Implantable / Q000009:adverse effects*; D020878:Device Removal; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery / Q000628:therapy*; D015641:Radiography, Interventional / Q000379:methods; D012086:Reoperation; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D013212:Staphylococcus epidermidis / Q000302:isolation & purification; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents
keywords: endocarditis; snare; vegetectomy