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Updated: Sep 12, 2025

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Minimally Invasive Aspiration of Tricuspid Valve Vegetation in Recurrent Methicillin-Susceptible Staphylococcus

Khaleel Quasem1, Michelle Carrasquel1, Haley Maser1

  • 1McLaren Greater Lansing, Lansing, Michigan, USA; Michigan State University, East Lansing, Michigan, USA.

JACC. Case Reports
|August 6, 2025
PubMed
Abstract

Insights

Percutaneous aspiration offers a less-invasive option for managing right-sided infective endocarditis (IE) in patients refusing surgery. Guidewire-assisted catheter navigation enhances vegetation debulking and improves outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Infectious Diseases

Background:

  • Right-sided infective endocarditis (IE) poses management challenges, particularly in intravenous drug users who decline surgery.
  • Percutaneous aspiration techniques present a minimally invasive alternative for IE treatment.

Observation:

  • A 32-year-old male with a history of intravenous drug use presented with methicillin-susceptible Staphylococcus aureus bacteremia and septic pulmonary emboli.
  • Transesophageal echocardiography identified a 1.5-cm mobile tricuspid vegetation; the patient declined surgical intervention.
  • Percutaneous aspiration was performed under echocardiographic guidance using a Penumbra FLASH catheter with guidewire assistance.

Findings:

  • The procedure successfully debulked the tricuspid vegetation.
  • The patient achieved clearance of bacteremia without complications.
  • This case highlights the adjunctive use of a coronary guidewire to improve catheter steering and efficacy.

Implications:

  • Catheter-based vegetectomy is an emerging salvage or bridge-to-surgery strategy for IE.
  • Percutaneous aspiration can be an effective source control method for tricuspid IE when surgery is contraindicated or declined.
  • Guidewire-assisted catheter navigation may enhance procedural success rates in minimally invasive IE interventions.
Keywords:
catheterizationintravenous drug useminimally invasivetricuspid endocarditisvacuum therapyvegetectomy

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