A novel percutaneous device to aid in treatment of tricuspid endocarditis

Abstract

The AngioVac System is utilized for the removal of the thrombus. High-risk surgical patients who present with severe valve disease secondary to endocarditis can be treated with the AngioVac system, hence mitigating the risks for this patient population. We describe a 56-year-old African American male who presented to the hospital due to infected pacemaker lead. During the lead extraction procedure, residual vegetations of 3 x 1.5 cm on the atrial aspect of the tricuspid valve and 1.5 x 1.2 cm on the ventricular aspect were discovered. We approached with the AngioVac system, due to high surgical risk, to decrease the vegetation burden to decrease septic emboli risk and greater penetration of the antibiotic therapy. Trans-esophageal echocardiography (TEE) demonstrated a significant reduction (>80%) in the size of the vegetations. This case illustrates the use of innovative medical technology, the AngioVac system, to remove the large vegetations with bacteremia on the tricuspid valve.