Key result
Percutaneous mechanical aspiration for left-sided prosthetic valve endocarditis linked to perivalvular abscess and pericardial effusion.
Why the study?
Prosthetic valve endocarditis carries high risk in poor surgical candidates after TAVR, and evidence is limited regarding percutaneous mechanical aspiration for left-sided endocarditis due to high complication risks.
Does percutaneous mechanical aspiration (PMA) cause complications in patients with left-sided prosthetic aortic valve endocarditis?
Case Report (n=1)
Does percutaneous mechanical aspiration (PMA) cause complications in patients with left-sided prosthetic aortic valve endocarditis?
Percutaneous mechanical aspiration for left-sided endocarditis carries a high risk of complications but may serve as salvage therapy in poor surgical candidates.
Should not yet change practice in TAVR endocarditis; leaves open role of PMA in poor surgical candidates.
BACKGROUND: Prosthetic valve endocarditis is a dreaded complication after transcatheter aortic valve replacement, especially in older patients with multiple comorbidities, who are poor surgical candidates. We describe a case of prosthetic aortic valve endocarditis in a patient who underwent percutaneous mechanical aspiration (PMA) and its sequelae over the following year. CASE SUMMARY: The patient presented with fever and chills after flu and respiratory syncytial virus vaccines and was found to have positive blood cultures for methicillin-resistant Staphylococcus aureus and bioprosthetic aortic valve endocarditis. He was a poor surgical candidate and underwent PMA with an AngioVac device with the development of a perivalvular abscess and pericardial effusion on subsequent admissions. DISCUSSION: PMA is increasingly being used for the treatment of endocarditis, especially right sided, but there is limited evidence on its use in left-sided endocarditis due to high risk of complications. TAKE-HOME MESSAGE: There is a high risk of complications with PMA in left-sided endocarditis, but it can be used as salvage therapy in poor surgical candidates.
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Kuwar et al. (2026) conducted a case report in Prosthetic aortic valve endocarditis (n=1). Percutaneous mechanical aspiration (PMA) with an AngioVac device was evaluated on Development of sequelae including perivalvular abscess and pericardial effusion. Percutaneous mechanical aspiration for left-sided prosthetic valve endocarditis in a poor surgical candidate was followed by the development of a perivalvular abscess and pericardial effusion.
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