Bennet George1, Anthony Voelkel2, John Kotter1, Andrew Leventhal1, John Gurley1. 1. Department of Cardiovascular Medicine, Gill Heart & Vascular Institute, University of Kentucky Medical Center, Lexington, Kentucky. 2. Department of Cardiovascular Medicine, Ohio State University Wexner Medical Center, Columbus, Ohio.
Abstract
BACKGROUND: Tricuspid valve surgery has been the de facto standard treatment for tricuspid valve endocarditis (TVE) refractory to medical therapy. It is now possible to remove right-sided vegetations percutaneously using a venous drainage cannula with an extracorporeal bypass circuit. OBJECTIVES: The purpose of our study is to describe our single-center experience of percutaneous tricuspid valve vegetation removal. METHODS: We reviewed the perioperative course of 33 consecutive patients with large tricuspid valve vegetations who carried high surgical risk. RESULTS: The cohort included 12 males and 21 females over a 40-month period with an average age of 37 years. A preponderance of patients carried an admitted or confirmed diagnosis of injection drug use (72.7%). Average vegetation size was 2.1 +/- 0.7 cm prior to the procedure with a 61% reduction in size after the procedure. All patients survived the procedure and 90.9% survived the index hospitalization. Three patients proceeded to elective tricuspid valve replacement due to worsening severity of tricuspid regurgitation. CONCLUSION: Percutaneous removal of large tricuspid valve vegetations is a safe and effective alternative for patients with TVE who carry high-surgical risk.
BACKGROUND: Tricuspid valve surgery has been the de facto standard treatment for tricuspid valve endocarditis (TVE) refractory to medical therapy. It is now possible to remove right-sided vegetations percutaneously using a venous drainage cannula with an extracorporeal bypass circuit. OBJECTIVES: The purpose of our study is to describe our single-center experience of percutaneous tricuspid valve vegetation removal. METHODS: We reviewed the perioperative course of 33 consecutive patients with large tricuspid valve vegetations who carried high surgical risk. RESULTS: The cohort included 12 males and 21 females over a 40-month period with an average age of 37 years. A preponderance of patients carried an admitted or confirmed diagnosis of injection drug use (72.7%). Average vegetation size was 2.1 +/- 0.7 cm prior to the procedure with a 61% reduction in size after the procedure. All patients survived the procedure and 90.9% survived the index hospitalization. Three patients proceeded to elective tricuspid valve replacement due to worsening severity of tricuspid regurgitation. CONCLUSION: Percutaneous removal of large tricuspid valve vegetations is a safe and effective alternative for patients with TVE who carry high-surgical risk.
Authors: Darshali A Vyas; Lucas Marinacci; Benjamin Bearnot; Sarah E Wakeman; Thoralf M Sundt; Arminder S Jassar; Virginia A Triant; Sandra B Nelson; David M Dudzinski; Molly L Paras Journal: Open Forum Infect Dis Date: 2022-03-02 Impact factor: 3.835
Authors: Jessica G Y Luc; Jae-Hwan Choi; Karishma Kodia; Matthew P Weber; Dylan P Horan; Elizabeth J Maynes; Laura A Carlson; H Todd Massey; John W Entwistle; Rohinton J Morris; Vakhtang Tchantchaleishvili Journal: Ann Cardiothorac Surg Date: 2019-11