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Case Reports
. 2016 Jan;8(1):E137-9.
doi: 10.3978/j.issn.2072-1439.2016.01.02.

A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis

George Makdisi  1 , Thomas Casciani  1 , Thomas C Wozniak  1 , David W Roe  1 , Zubair A Hashmi  1
Affiliations
Case Reports

A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis

George Makdisi et al. J Thorac Dis. 2016 Jan.

Abstract

Timing of surgical management of acute infective endocarditis is a major challenge, with respect to surgical complications, risks of recurrences and optimal valve repair or replacement. We present a case of a 24-year-old male with a history of intravenous drug abuse, who was referred to our center after 10 days of medical management of acute infective endocarditis. Upon arrival he was in septic shock, multi-organ failure, and mobile vegetations on the tricuspid valve with severe tricuspid regurgitation. He also had bilateral pulmonary infarcts and an ischemic stroke in the right parietal lobe. A successful percutaneous transcatheter mechanical vegetation debulking was performed followed by surgical valve replacement seven days later. This case introduces a new option in the management of right-sided endocarditis in critically ill patient, and demonstrates the technical feasibility of a debulking procedure in this setting, which led subsequently to a significant improvement in patient's condition, and he was ultimately able to undergo definitive surgery.

Keywords: AngioVAC; Endocarditis; debulking; tricuspid valve; vegetation.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Tricuspid valve vegetation (pre percutaneous debulking echocardiography).
Figure 2
Figure 2
Removed vegetations. (A) Vegetations in the AngioVac™ container; (B) vegetations removed by AngioVac™.
Figure 3
Figure 3
Tricuspid valve (pre percutaneous debulking echocardiography).
See this image and copyright information in PMC

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