AngioVac for Minimally Invasive Removal of Intravascular and Intracardiac Masses: a Systematic Review

Enezate, Tariq; Alkhatib, Deya; Raja, Joel; Chinta, Viswanatha; Patel, Mitul; Omran, Jad

doi:10.1007/s11886-022-01658-9

Cited by 12 publications

(6 citation statements)

References 28 publications

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“…AngioVac was approved by FDA in 2009 for the removal of unwanted material from the vascular system and has been used as early as 2011 in the removal of complex masses from the right atrium [33]. In a meta-analysis of the AngioVac catheter device system use in caval thromboemboli, right-sided cardiac masses, catheter-related thrombosis, and pulmonary embolism, the success rate was 73.6%, with reported access site complications including bleeding, hematoma, and distal embolization [34]. Rajput et al reported 16 patients who had intracardiac masses aspirated using the AngioVac device catheter system; none had access site complications and all were successfully closed using Perclose device [35].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Intracardiac Mass Extraction in High Surgical-Risk Patients

Riad,

Rahman,

Mulyala

et al. 2023

J Med Cases

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Large intracardiac masses including tumors, thrombi, and vegetations result in detrimental embolic or obstructive sequelae and present a management dilemma. Open heart surgery, the traditional approach, may not be an option for many patients with a prohibitive surgical risk due to multiple comorbidities. Recently, percutaneous options have emerged with reported success in extracting such intracardiac masses. A 42-yearold female with history of advanced primary sclerosing cholangitis with decompensated liver cirrhosis causing ascites and variceal bleed presented to the emergency department with fatigue, subjective fevers, chills and melena. Laboratory results revealed neutrophil-predominant leukocytosis and normocytic anemia, and blood cultures were positive for Candida albicans. Electrocardiography showed sinus tachycardia. Chest X-ray was unremarkable. She underwent packed red blood cell transfusion and esophageal banding for variceal bleeding. Transthoracic echocardiogram revealed normal left ventricular ejection fraction and no wall motion abnormalities. A right atrial mobile mass measuring approximately 1.0 × 3.0 cm was noted. Multidisciplinary heart team discussion concluded that while the mass posed a high embolic risk, the patient had a prohibitive risk for surgical intervention. Successful percutaneous removal of the mass using Penumbra system device (Penumbra Incorporated, Alameda, CA) was accomplished. This case report details the procedure and outcomes, as well as presents a literature review.

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Section: Discussionmentioning

confidence: 99%

Percutaneous Intracardiac Mass Extraction in High Surgical-Risk Patients

Riad,

Rahman,

Mulyala

et al. 2023

J Med Cases

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“…Percutaneous aspiration of vegetations from the tricuspid valve has been reported with increasing frequency in the last decade [162,163]. This procedure is performed by placing the patient on an extracorporeal circulatory circuit through large bore venous drainage and venous return cannulas.…”

Section: Percutaneous Aspirationmentioning

confidence: 99%

Injection Drug Use-Associated Infective Endocarditis

Barnes¹,

Cook²

2023

Endocarditis - Diagnosis and Treatment

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Injection drug use-associated presents is a unique entity. The demographics of those affected and the clinical presentation are markedly different from those with endocarditis due to other causes. This group presents with a high proportion of right sided valve involvement, distinct pathophysiology, and a more varied array of infectious causes. The best management of these patients regarding medications and surgery remain hotly contested. The increased use of oral antibiotics and novel treatment techniques may expand safe and effective treatment for this group of patients.

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“…Other indications which have been described include debridement of right-sided endocarditis, reduction in thrombus burden in a pulmonary embolus, and utilization for capturing particulate matter in cases where embolic material may be a threat (i.e. indwelling catheter or device-related thrombus or vegetation) [ 6 ]. In this approach, an aspiration cannula is inserted into one of the major veins and connected to a veno-venous bypass circuit which then captures the aspirated debris.…”

Section: Introductionmentioning

confidence: 99%

“…In this approach, an aspiration cannula is inserted into one of the major veins and connected to a veno-venous bypass circuit which then captures the aspirated debris. Although there have been case series that focus on the reduction in thrombus burden and hospital survival, data are lacking on the impact of these devices long-term on survival and patient outcomes [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%