Repeat AngioVac Debulking of a Large Right Atrial Thrombus With Extension From the Hepatic Vein

The AngioVac mechanical aspiration system has emerged in the literature as a viable treatment option for patients with intracardiac masses and thrombi and who are deemed high risk for cardiac surgery. Notably, it has been shown to be an effective treatment modality for the debulking of thrombi in the setting of malignancy. We present a case of repeat AngioVac debulking of a large right atrial thrombus with extension from the hepatic vein in the setting of advanced malignancy complicated by Enterococcus faecium endocarditis.