A novel approach in the management of right-sided endocarditis: percutaneous vegectomy using the AngioVac cannula.
The AngioVac is a vacuum-based device introduced in 2012 to percutaneously remove undesirable material from the intravascular system. In scattered reports, the AngioVac has been used for removal of device-led vegetations and right-sided thrombi. In this article, we describe three cases of right-sided endocarditis treated with AngioVac: a mobile mass extending from the vena cava into the right atrium, large native tricuspid vegetations, and bioprosthetic tricuspid vegetations. This device shows benefit in reducing vegetation load, decreasing septic lung embolization, and reducing reinfection in active intravenous drug users. These cases exhibit the AngioVac's arrival as a new and exciting tool in endocarditis treatment, providing an alternative to open surgery and accessorizing antimicrobial treatment.
Department of Cardiology, Harper University Hospital, 3990 John R Rd, 4 Hudson, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Ashwin K
AK
Thiagaraj
Department of Infectious Diseases, Harper University Hospital, 3990 John R Rd, 5 Hudson, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Meenal
M
Malviya
Department of Interventional Cardiology, Detroit Medical Center, Wayne State University, 311 Mack Ave, Detroit, MI 48201, USA.
Wah W
WW
Htun
Department of Cardiology, Harper University Hospital, 3990 John R Rd, 4 Hudson, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Tesfaye
T
Telila
Department of Infectious Diseases, Harper University Hospital, 3990 John R Rd, 5 Hudson, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA.
Stephen A
SA
Lerner
Department of Interventional Cardiology, Detroit Medical Center, Wayne State University, 311 Mack Ave, Detroit, MI 48201, USA.
Mahir D
MD
Elder
Department of Interventional Cardiology, Detroit Medical Center, Wayne State University, 311 Mack Ave, Detroit, MI 48201, USA.
Theodore L
TL
Schreiber
D000328:Adult; D000072601:Cannula; D004697:Endocarditis, Bacterial / Q000473:pathology / Q000628:therapy*; D005260:Female; D006325:Heart Atria; D006331:Heart Diseases / Q000628:therapy*; D006349:Heart Valve Diseases / Q000473:pathology / Q000628:therapy*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D013927:Thrombosis / Q000628:therapy*; D014261:Tricuspid Valve; D014618:Vacuum
AngioVac; cardiac surgery; endocarditis; interventional; minimally invasive; percutaneous; tricuspid valve; valvular disease; vegectomy