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

George Makdisi, Thomas Casciani, Thomas C. Wozniak, David W. Roe, Zubair A. Hashmi

Research output: Contribution to journalArticle

14 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)E137-E139
JournalJournal of Thoracic Disease
Volume8
Issue number1
DOIs
StatePublished - 2016

Fingerprint

Tricuspid Valve
Endocarditis
Intravenous Substance Abuse
Tricuspid Valve Insufficiency
Parietal Lobe
Septic Shock
Surgical Instruments
Critical Illness
Stroke
Recurrence
Lung

Keywords

  • AngioVAC
  • Debulking
  • Endocarditis
  • Tricuspid valve
  • Vegetation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis. / Makdisi, George; Casciani, Thomas; Wozniak, Thomas C.; Roe, David W.; Hashmi, Zubair A.

In: Journal of Thoracic Disease, Vol. 8, No. 1, 2016, p. E137-E139.

Research output: Contribution to journalArticle

Makdisi, George ; Casciani, Thomas ; Wozniak, Thomas C. ; Roe, David W. ; Hashmi, Zubair A. / A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis. In: Journal of Thoracic Disease. 2016 ; Vol. 8, No. 1. pp. E137-E139.
@article{c57bc826b10d47cb88612f891115d391,
title = "A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis",
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, Debulking, Endocarditis, Tricuspid valve, Vegetation",
author = "George Makdisi and Thomas Casciani and Wozniak, {Thomas C.} and Roe, {David W.} and Hashmi, {Zubair A.}",
year = "2016",
doi = "10.3978/j.issn.2072-1439.2016.01.02",
language = "English (US)",
volume = "8",
pages = "E137--E139",
journal = "Journal of Thoracic Disease",
issn = "2072-1439",
publisher = "Pioneer Bioscience Publishing Company (PBPC)",
number = "1",

}

TY - JOUR

T1 - A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis

AU - Makdisi, George

AU - Casciani, Thomas

AU - Wozniak, Thomas C.

AU - Roe, David W.

AU - Hashmi, Zubair A.

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

KW - AngioVAC

KW - Debulking

KW - Endocarditis

KW - Tricuspid valve

KW - Vegetation

UR - http://www.scopus.com/inward/record.url?scp=84957104049&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957104049&partnerID=8YFLogxK

U2 - 10.3978/j.issn.2072-1439.2016.01.02

DO - 10.3978/j.issn.2072-1439.2016.01.02

M3 - Article

AN - SCOPUS:84957104049

VL - 8

SP - E137-E139

JO - Journal of Thoracic Disease

JF - Journal of Thoracic Disease

SN - 2072-1439

IS - 1

ER -