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CSI

POSTER SESSION #4

(P096) SINGLE CANADIAN CENTER EXPERIENCE USING ANGIOVAC FOR PERCUTANEOUS DEBULKING OF TRICUSPID VALVE ENDOCARDITIS

Friday, October 25, 2024
1:30 PM – 2:00 PM PT
Location: BOARD 52

    Presenting Author(s)

  • KM

    Kamal Matli, MD

    Interventional and Structural Cardiology Fellow
    Centre Hospitalier de L'Université de Montréal (CHUM)
    Montréal, Quebec, Canada

    • First Author(s)

  • KM

    Kamal Matli, MD

    Interventional and Structural Cardiology Fellow
    Centre Hospitalier de L'Université de Montréal (CHUM)
    Montréal, Quebec, Canada

    • Co-Author(s)

  • JP

    Jeannot Potvin, MD

    Cardiologist
    Centre hospitalier de l'Université de Montréal
    Montreal, Quebec, Canada

  • JM

    Jean-Bernard Masson, MD

    Associate Professor
    Montreal, Quebec, Canada

  • EJ

    E. Marc Jolicoeur, MD MSc

    Cardiologist
    Montreal, Quebec, Canada

  • LS

    Louis-Mathieu Stevens, MD

    Associate Professor
    Montreal, Quebec, Canada

  • JF

    Jessica Forcillo, MD PhD MPH

    Cardiac surgeon, full professor tenured, department of surgery, Université de Montréal
    Centre hospitalier université de Montréal
    Montréal, Quebec, Canada

  • Nicolas Noiseux, MD

    Cardiac Surgeon
    Montreal University
    Universite de Montreal
    Montreal, Quebec, Canada

  • Mounir Riahi, MD

    Associate Professor
    St Paul's hospital
    University of British Columbia
    Montreal, Quebec, Canada

    • Senior Author(s)

  • Mounir Riahi, MD

    Associate Professor
    St Paul's hospital
    University of British Columbia
    Montreal, Quebec, Canada

    • Supervisor(s)

  • Mounir Riahi, MD

    Associate Professor
    St Paul's hospital
    University of British Columbia
    Montreal, Quebec, Canada

Disclosure(s):
Kamal Matli, MD: No financial relationships to disclose


Background: We describe our experience with percutaneous extraction of tricuspid valve (TV) vegetations using the mechanical aspiration system AngioVac (AngioDynamics, New York) as an alternative to conventional surgical treatment.

METHODS AND RESULTS: This is a retrospective analysis of all consecutive percutaneous TV vegetation extraction procedures between January 2022 and December 2023 at a single high volume academic center. A total of six procedures were performed in a cohort of five patients with an average age of 42 years. Three patients had a history of recent intravenous drug use. All patients had bacteremia with echocardiographic findings of TV vegetations. Baseline echocardiographic data shows a mass size ranging from 10 mm to 30mm. Post procedural echocardiogram revealed successful mass debulking defined as > 50 % mass removal in 100 % of the cases . TR severity increased significantly in 2 patients. One required non-urgent surgical valve replacement due to valvular perforation and the second was treated medically since he was asymptomatic and at high risk for surgery . One patient had a repeat Angiovac procedure due to evidence of recurrent vegetation secondary to inappropriate antibiotherapy . In hospital and 30 days survival was 100% with a mean hospital stay of 31.4 days. No urgent surgical conversion or need for mechanical support was observed.

Conclusion: Percutaneous extraction of TV endocarditis using the AngioVac system is safe and effective. This less invasive procedure can avoid the potential morbidity, long ICU stay and high cost associated with conventional open-heart surgical therapy.