Percutaneous vacuum-assisted clot extraction using the AngioVac system may be an effective salvage therapy for right-sided endocarditis with persistent bacteraemia after device extraction.
May support AngioVac as salvage option in refractory right-sided endocarditis; hypothesis-generating from single case and requires prospective validation.
A 56-year-old woman with non-ischaemic cardiomyopathy with implantable cardioverter defibrillator (ICD) presented to the hospital with progressive dyspnoea of 4 weeks’ duration. She soon spiralled down to develop septic shock with methicillin-sensitiveStaphylococcus aureusbacteraemia. A transoesophageal echocardiogram revealed a 2.4×2.1 cm large mobile echodensity in the right atrium likely attached to the ICD lead and to the interatrial septum. Although the ICD along with its leads was extracted, bacteraemia persisted despite appropriate antibiotic therapy. Because of her worsening condition, she underwent a right atrial infected clot extraction by the AngioVac system. Her clinical condition noticeably improved soon after evacuation of the infected clot.
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Ahmed et al. (2018) studied this question.
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