Key result
Suction debulking for isolated tricuspid valve endocarditis had similar all-cause mortality to surgery (12.5% vs 10.3%, P>0.99) but a higher need for reintervention (50.0% vs 17.2%, P=0.048).
Why the study?
Data comparing the feasibility and short-term outcomes of percutaneous vegetation debulking to conventional open surgical strategies in tricuspid valve infective endocarditis were limited.
Does suction debulking with partial venovenous bypass improve outcomes compared to conventional open surgery in patients with isolated tricuspid valve infective endocarditis?
Cohort (n=45)
No
Does suction debulking with partial venovenous bypass improve outcomes compared to conventional open surgery in patients with isolated tricuspid valve infective endocarditis?
Suction debulking is a feasible initial therapy for isolated tricuspid valve endocarditis, offering shorter procedure times and similar mortality to surgery, despite a higher reintervention rate.
Suction debulking may be considered initial therapy in high-risk isolated TVIE; leaves open need for randomized trials to assess reintervention risk.
Objective: Percutaneous vegetation debulking has been reported to treat tricuspid valve infective endocarditis (TVIE), but data on feasibility compared with conventional surgical strategies are limited. We aimed to compare short-term outcomes of suction debulking with partial venovenous bypass to conventional open surgery in this population. Methods: This was a single-center, retrospective study that included all patients with isolated TVIE who underwent suction debulking with partial venovenous bypass or tricuspid valve surgery between January 2010 and December 2022. Patient characteristics, procedural data, and clinical outcomes were compared. Results: Of the 45 patients included, 16 (35.6%) underwent suction debulking and the remainder (64.4%) underwent surgery. Baseline characteristics were comparable, including high rates of preprocedure hemodialysis (11.1%), prior infectious endocarditis (44.4%), intravenous drug use (60.0%), presence of tricuspid bioprostheses (24.4%), and septic shock (40.0%). Suction debulking had a shorter procedure time than surgery (206 [176 to 224] min vs 400 [325 to 487] min, P < 0.001) and was associated with numerically lower rates of various complications including acute kidney injury requiring hemodialysis, limb ischemia, and dysrhythmia requiring pacemaker. Over a mean follow-up period of 473 ± 604 days, recurrent endocarditis (37.5% vs 17.2%, P = 0.25) and the need for reintervention (50.0% vs 17.2%, P = 0.048) were higher with suction debulking. However, all-cause mortality was similar between the groups (12.5% vs 10.3%, P > 0.99). Conclusions: Suction debulking can safely be performed in patients with isolated TVIE with shorter procedural times and similar midterm all-cause mortality compared with surgery. Suction debulking may be appropriate initial therapy for this complex population.
No takes yet. Share an insight, caveat, or question.
Modi et al. (2025) conducted a cohort in Isolated tricuspid valve endocarditis (n=45). Suction debulking with partial venovenous bypass vs. Conventional open surgery was evaluated on All-cause mortality (p=>0.99). Suction debulking for isolated tricuspid valve endocarditis had similar all-cause mortality to surgery (12.5% vs 10.3%, P>0.99) but a higher need for reintervention (50.0% vs 17.2%, P=0.048).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: