Bansal Nahush, Younes Stephanie, Maaieh Mohammed
Department of Internal Medicine, The University of Toledo, Toledo, USA.
Department of Cardiology, ProMedica Toledo Hospital, Toledo, USA.
Cureus. 2024 Mar 20;16(3):e56537. doi: 10.7759/cureus.56537. eCollection 2024 Mar.
The Angiovac aspiration system has been used successfully for the removal of intravascular material or thrombus in the right-sided heart structures, vena cava, implantable cardiac defibrillator, or other devices. For infective endocarditis, it is reserved for the patients who warrant but are not good candidates for the surgery. The evidence regarding Angiovac aspiration of the infective endocarditis of the left-sided heart valves is scarce. The risk of complications, including thrombi fragmentation leading to systemic embolization, damage to the cardiac structures and tissue, and hemodynamic instability, precludes the widespread use of this procedure, especially for the left-sided lesions. We report a case of successful removal of the mitral valve endocarditis using the Angiovac aspiration technique under the TEE guidance. A SENTINEL™ cerebral protection system was used to prevent embolus migration and a venous rather than an arterial access was used for reperfusion.
Angiovac抽吸系统已成功用于清除右侧心脏结构、腔静脉、植入式心脏除颤器或其他装置中的血管内物质或血栓。对于感染性心内膜炎，它仅适用于有手术指征但不适合手术的患者。关于使用Angiovac抽吸治疗左侧心脏瓣膜感染性心内膜炎的证据很少。并发症风险，包括血栓破碎导致全身栓塞、心脏结构和组织损伤以及血流动力学不稳定，限制了该手术的广泛应用，尤其是对于左侧病变。我们报告一例在经食管超声心动图（TEE）引导下使用Angiovac抽吸技术成功清除二尖瓣心内膜炎的病例。使用了SENTINEL™脑保护系统来防止栓子迁移，并采用静脉而非动脉通路进行再灌注。
