Key result
A 62-year-old male with IV drug use and tricuspid valve endocarditis complicated by septic pulmonary emboli was treated with IV antibiotics and evaluated for AngioVAC vegetation extraction.
Case Report (n=1)
Transcatheter aspiration via the AngioVac system is a viable option for vegetation debulking in patients with tricuspid valve endocarditis who are poor surgical candidates.
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Raises awareness for septic emboli in IVDU tricuspid endocarditis; hypothesis-generating for surgical thresholds in similar cases.
Infective endocarditis is a multisystem disease. Tricuspid valve endocarditis is frequently seen in patients with intravenous (IV) drug users. Cavitating lung nodules predominantly in a peripheral location in IV drug users indicate the possibility of septic emboli. Large vegetation and persistent bacteremia with septic embolic phenomena are the most common indication for surgery. We present a case of a 62-year-old male with a history of IV drug use who presented with epigastric abdominal pain, pleuritic chest pain, and shortness of breath. CT chest showed cavitating lung nodules suggestive of septic pulmonary emboli. A transesophageal echocardiogram (TEE) showed tricuspid valve vegetation despite a normal transthoracic echocardiogram. The patient was treated with intravenous antibiotics. He was deemed a poor surgical candidate; therefore, he was transferred to a tertiary center for AngioVAC (AngioDynamics, Latham, New York).
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Elkattawy et al. (2022) conducted a case report in Tricuspid valve endocarditis (n=1). Intravenous antibiotics and AngioVAC evaluation was evaluated. A 62-year-old male with IV drug use and tricuspid valve endocarditis complicated by septic pulmonary emboli was treated with IV antibiotics and evaluated for AngioVAC vegetation extraction.
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