A successful percutaneous mechanical vegetation debulking used as a bridge to surgery in acute tricuspid valve endocarditis

Timing of surgical management of acute infective endocarditis is a major challenge, with respect to surgical complications, risks of recurrences and optimal valve repair or replacement. We present a case of a 24-year-old male with a history of intravenous drug abuse, who was referred to our center a...

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Bibliographic Details
Published in:Journal of thoracic disease 2016-01, Vol.8 (1), p.E137-E139
Main Authors: Makdisi, George, Casciani, Thomas, Wozniak, Thomas C, Roe, David W, Hashmi, Zubair A
Format: Article
Language:English
Subjects:
Case Report
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Summary:Timing of surgical management of acute infective endocarditis is a major challenge, with respect to surgical complications, risks of recurrences and optimal valve repair or replacement. We present a case of a 24-year-old male with a history of intravenous drug abuse, who was referred to our center after 10 days of medical management of acute infective endocarditis. Upon arrival he was in septic shock, multi-organ failure, and mobile vegetations on the tricuspid valve with severe tricuspid regurgitation. He also had bilateral pulmonary infarcts and an ischemic stroke in the right parietal lobe. A successful percutaneous transcatheter mechanical vegetation debulking was performed followed by surgical valve replacement seven days later. This case introduces a new option in the management of right-sided endocarditis in critically ill patient, and demonstrates the technical feasibility of a debulking procedure in this setting, which led subsequently to a significant improvement in patient's condition, and he was ultimately able to undergo definitive surgery.
ISSN:2072-1439
2077-6624
DOI:10.3978/j.issn.2072-1439.2016.01.02