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Published on: December 11, 2017
Prosthetic Aortic Valve Vegetation: A Percutaneous Mechanical Aspiration Approach
Justin Ortiz1, Eric D Saunders2, Joshua M Baker2
1Nova Southeastern University, Dr Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, Florida, USA.
Background:
Percutaneous mechanical aspiration has been well described for the removal of vegetations involving valves of the right side of the heart. However, only limited cases describe its use for the aortic valve.
Case Summary:
An 89-year-old man presented with methicillin-sensitive Staphylococcus aureus-positive infective endocarditis involving a bioprosthetic aortic valve and was determined to be high risk for surgery, He therefore underwent percutaneous mechanical aspiration to remove a vegetation.
Discussion:
Infective endocarditis is a life-threatening condition for which high-risk surgical candidates are at increased risk of related morbidity and mortality. This case highlights the potential important role of percutaneous mechanical aspiration in debulking vegetations in nonsurgical candidates. This case also discusses the use of cerebral protection to minimize the risk of procedure-related cerebral embolism.
Take-Home Messages:
Percutaneous mechanical aspiration offers a feasible treatment strategy for high-risk patients with aortic valve endocarditis in whom surgery may be precluded. However, additional studies are needed.
Insights
Percutaneous mechanical aspiration successfully removed aortic valve vegetations in a high-risk patient unsuitable for surgery. This minimally invasive technique shows promise for treating infective endocarditis when traditional surgery is not an option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Infective Endocarditis Management
Background:
- Percutaneous mechanical aspiration is established for right-sided heart valve vegetations.
- Limited data exists on its application for aortic valve vegetations.
