Percutaneous aspiration of vegetation from tricuspid valve infective endocarditis

We present a novel minimally invasive percutaneous approach for the surgical treatment of tricuspid valve infective endocarditis. In this case, the patient presented with a malfunctioning implantable cardiac device, right ventricle implantable cardiac device lead infection, and infective endocarditis of the tricuspid valve.   The infective endocarditis vegetations were removed via a percutaneous approach using the AngioVac suction device. The device was modified by the surgeon, who sutured 2 threads to the head of the device in order to allow adjustments to be made to the angle of suction by applying tension on the suture. Real-time visualization of the procedure was achieved via transesophageal echocardiography.   This approach, utilizing the AngioVac device, is a feasible and effective treatment strategy for endocarditis vegetation removal in selected patients who would otherwise be unsuitable candidates for open heart surgery.