Methods: In our series, we describe three cases of right-sided endocarditis treated with AngioVac at our medical center.
Results: In case 1, a 35 year old man admitted with methicillin-susceptible Staphylococcus aureus bacteremia and septic shock after a mobile 4.5 cm mass was noted extending from the superior vena cava into the right atrium, and traversing the tricuspid valve during diastole. This mass was removed with AngioVac and later confirmed as vegetation. In case 2, a 28 year-old woman with a history of IV heroin use presented with methicillin-resistant Staphylococcus aureus bacteremia and resulting septic shock. Trans-esophageal echocardiogram confirmed tricuspid vegetations on the anterior and posterior leaflets that were larger than prior causing tricuspid regurgitation and septic pulmonary emboli. AngioVac was used to remove the vegetations despite being on appropriate antibiotics for 20 days. In case 3, a 58 year-old woman with a recently placed bioprosthetic tricuspid valve and IV heroin use was admitted to the hospital with Enterococcus faecalis bacteremia, a 3.2 cm tricuspid valve vegetation, and resulting moderate tricuspid regurgitation. The AngioVac was used to debulk this vegetation, with resulting improvement in tricuspid regurgitation.
Conclusion: These cases the promise of the AngioVac as a new approach in endocarditis treatment, providing an alternative to open surgery and as an accessory to antimicrobial treatment.
M. Malviya, None
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