The AngioVac system as a bail-out option in infective valve endocarditis

Starck, Christoph; Dreizler, Thomas; Falk, Volkmar

doi:10.21037/acs.2019.11.04

Cited by 31 publications

(21 citation statements)

References 8 publications

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“…6 A recently published editorial referenced a case series of 78 patients treated with Angiovac; however, the authors did not report their survival statistics. 21 Our data combined with that from George et al 6 Using this definition we found an impressive 86% success rate.…”

Section: Preoperative Characteristicssupporting

confidence: 67%

Vacuum‐assisted extraction of ilio‐caval and right heart masses: A 5‐year single center experience

Newman¹,

Patel

Keeling

et al. 2020

J Card Surg

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Purpose Despite paucity of data, there exists growing popularity of catheter‐based extraction methods for intravascular thrombi and vegetations. We describe a large single center experience with vacuum‐assisted extraction techniques (VAET) for right‐sided intravascular and cardiac masses. Methods We retrospectively reviewed the perioperative course of patients undergoing VAET between 2014 and 2019. Primary outcomes were survival and freedom from recurrent bacteremia. Procedural success was a composite definition of survival, majority of mass extraction, absence of recurrent bacteremia, and valve function not requiring further intervention during index hospitalization. Results Of the entire cohort (n = 58), 48% and 52% underwent VAET for vegetations and sterile thrombi, respectively. Of those with positive cultures, the most common organism isolated was Staphylococcus aureus (48%). Preoperative active bacteremia was present in 36% (21/58) and of these patients, 76% (16/21) had neither recurrent nor persistent bacteremia post‐op. The majority of masses (67%, 38/58) were debulked with an average reduction in size of 42%. Conversion to open surgery occurred in 3.5% (2/58). Intraoperative and 30‐day survival were 98% (57/58) and 90% (28/31), respectively. Overall success was 86% (50/58). The prevalence of moderate/severe tricuspid regurgitation was 37% pre‐op and 61% post‐op. Average length of intensive care unit and overall hospital stay was 5.6 and 16 days, respectively. Conclusions In this single center experience, VAET was conducted safely with a high degree of success and freedom from short‐term recurrent bacteremia. This minimally invasive procedure is an attractive alternative to traditional open techniques for removal of right‐sided intravascular and cardiac masses.

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Section: Preoperative Characteristicssupporting

confidence: 67%

Vacuum‐assisted extraction of ilio‐caval and right heart masses: A 5‐year single center experience

Newman¹,

Patel

Keeling

et al. 2020

J Card Surg

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show abstract

“…The procedure can also be done to reduce complications of surgery, increase the efficacy of antibiotics, and can be used as a bridge to surgery or as an alternative in patients with high perioperative risk [ 14 - 15 ]. Complications of the AngioVac® procedure include vascular or myocardial injury, pericardial tamponade, tricuspid valve injury, or pulmonary embolism [ 16 ]. Following treatment of IE, an additional TTE or TEE should be done to establish a new baseline of heart function.…”

Section: Discussionmentioning

confidence: 99%

Serratia marcescens Tricuspid Valve Vegetation and Successful Use of the AngioVac® System

Winkle¹,

Gaballa²,

Memon³

et al. 2020

Cureus

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Serratia marcescens bacteremia is common in patient populations with a history of intravenous drug use (IVDU), but it rarely causes infective endocarditis. We are reporting a 27-year-old female with a medical history significant for IVDU and hepatitis C virus infection who presented to the emergency department complaining of fever and shortness of breath. Computed tomography of the chest with intravenous (IV) contrast revealed extensive bilateral pulmonary infiltrates with multiple cavitary lesions. The patient was treated with IV vancomycin and piperacillin/tazobactam. Blood culture grows methicillin-sensitive Staphylococcus aureus (MSSA) and S. marcescens , both sensitive to cefepime/meropenem. Transesophageal echocardiogram revealed 3.4 x 2 cm tricuspid valve vegetation. Cardiothoracic surgery was consulted, who recommended transcatheter aspiration with the AngioVac® system (AngioDynamics Inc., Latham, NY). Post-procedure transesophageal echocardiogram revealed a significant reduction of vegetation size. Vegetation tissue culture grew MSSA and S. marcescens . The repeated blood culture revealed no growth, and the patient significantly improved clinically. She completed a six-week course of IV meropenem as an inpatient until she was discharged home.

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“…1 IDU-IE typically involves the tricuspid valve (tricuspid valve infective endocarditis [TVIE]), and Staphylococcus aureus is the highly virulent pathogen most frequently isolated in this setting. 2 Current IE guidelines recommend long-term antibiotic treatment in combination with surgical intervention through valve surgery in patients with serious complications, including valve regurgitation, heart failure, persistence of infection, or large vegetation size. 3 Valve surgery can be life-saving but remains controversial in people who inject drugs (PWID) due to perceived risks of prosthetic valve reinfection because of recidivism.…”

mentioning

confidence: 99%

“…10 PMA has been shown to be an effective method in debulking large TV vegetations. 2,11 The debulking concept aims to reduce bacterial load and inoculum size, enhance antimicrobial treatment efficacy in clearing bloodstream infections, and decrease the risk of systemic embolization. Debulking can act as a bridge to valve surgery after stabilization of patients with high surgical risks, such as PWID.…”

mentioning

confidence: 99%

“…Debulking can act as a bridge to valve surgery after stabilization of patients with high surgical risks, such as PWID. 2,[11][12][13][14] Most TV debulking case reports have used the AngioVac system (AngioDynamics, Latham, NY), which was initially approved by the U.S. Food and Drug Administration in 2014 for the removal of intravascular emboli and thrombi. 2,11,[15][16][17] Multiple observational and case report studies have suggested that PMA is associated with good outcomes in PWID with IE, but these data are difficult to interpret because of the lack of a comparator group.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous Mechanical Aspiration vs Valve Surgery for Tricuspid Valve Endocarditis in People Who Inject Drugs

Veve

Akhtar

McKeown

et al. 2021

The Annals of Thoracic Surgery

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The AngioVac system as a bail-out option in infective valve endocarditis

Cited by 31 publications

References 8 publications

Vacuum‐assisted extraction of ilio‐caval and right heart masses: A 5‐year single center experience

Vacuum‐assisted extraction of ilio‐caval and right heart masses: A 5‐year single center experience

Serratia marcescens Tricuspid Valve Vegetation and Successful Use of the AngioVac® System

Percutaneous Mechanical Aspiration vs Valve Surgery for Tricuspid Valve Endocarditis in People Who Inject Drugs

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