DECREASING DISEASE BURDEN OF RIGHT HEART ENDOCARDITIS USING ANGIOVAC TECHNOLOGY IN PATIENTS WHO CANNOT TOLERATE SURGICAL INTERVENTIONS

TOPIC: Procedures TYPE: Medical Student/Resident Case Reports INTRODUCTION: The AngioVac device was designed with the purpose to percutaneously remove undesirable material from intravascular system. procedures have recently become popular for decreasing vegetative burden in patients infective endocarditis who are poor surgical candidates. CASE PRESENTATION: A 26-year-old female a previous history of intravenous drug use, MSSA bacteremia, and noncompliance presented acute hypoxic respiratory failure refractory septic shock. She found multiple cavitary lesions on CT angiography chest (Figure 1A) which consistent emboli. Transesophageal echocardiogram revealed large valvular vegetations anterior septal tricuspid valve leaflets measuring approximately 2cm x2cm component leaflet having independent mobility 1B). Despite directed antibiotic therapy, her clinical status continued deteriorate. Subsequently, decision made perform vegectomy debulking disease burden. Vegectomy performed successfully 1C 1D) significant improvement. DISCUSSION: Endocarditis right-heart circulation is most commonly managed antimicrobial therapy. Surgical indications complicated include: (=20 mm diameter), recurrent pulmonary emboli, presence highly resistant organism, and/or persistent bacteremia. In certain instances, where intervention not appropriate conditions such as unstable right heart endocarditis, has been utilized decrease CONCLUSIONS: use gaining attention, however, further studies needs be done efficacy safety this new possible indication. REFERENCE #1: Behrens, George, Haraldur Bjarnason. "Venous Thromboembolic Disease: Use Aspiration Thrombectomy Device AngioVac.” Seminars Interventional Radiology, Thieme Publishers, Dec. 2015 #2: Delahaye, F, et al. "Indications Optimal Timing Surgery Infective Endocarditis."Heart (British Cardiac Society), Copyright 2004 by Heart, June #3: DM, Bernard D. Prendergast and, "Surgery Endocarditis.” Circulation,9 Mar. 2010 DISCLOSURES: No relevant relationships Mohamed Abdelhabib, source=Web Response Basil Alkhatib, no disclosure file Ashish Pershad; Gabriel Ruiz, Abhishek Sawant; Zachary Wilson,