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 Scopus citations

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

Keywords

  • AngioVAC
  • Debulking
  • Endocarditis
  • Tricuspid valve
  • Vegetation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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