Department of Cardiology, National University Heart Centre, Singapore, Singapore.
Catheter Cardiovasc Interv. 2013 Nov 1;82(5):E750-3. doi: 10.1002/ccd.24994. Epub 2013 Jun 18.
A middle-aged male developed right-sided endocarditis from an infection of an implantable cardiac defibrillator (ICD) system. Following percutaneous device and lead explantation, a very large pedunculated vegetation (19 mm × 14 mm) was found on the Eustachian valve. We decided to remove the vegetation percutaneously using a wire snare instead of open heart surgery.
Real-time three-dimensional transesophageal echocardiography and fluoroscopy were used to guide the procedure. Access was from the right femoral vein. Using a triple-loop wire snare through a deflectable sheath, the vegetation was successfully removed in its entirety without complications.
Percutaneous snare vegetectomy is feasible and may be a viable option in place of open heart surgery in selected patients.
一名中年男性因植入式心脏除颤器（ICD）系统感染而出现右侧心内膜炎。在经皮器械和导线取出后，于欧氏瓣上发现一个非常大的有蒂赘生物（19mm×14mm）。我们决定使用线圈套器而非开胸手术经皮切除赘生物。
实时三维经食管超声心动图和透视用于引导该操作。经右股静脉入路。通过可弯曲鞘管使用三环线圈套器，成功完整地切除了赘生物，无并发症发生。
经皮圈套器赘生物切除术是可行的，在某些特定患者中可能替代开胸手术成为一种可行的选择。
