Staphylococcal tricuspid valve infective endocarditis complicated by refractory sepsis and bilateral lung abscesses successfully treated with adjunctive mechanical aspiration.

•In bulky infective vegetations, response to antibiotic therapy can be unpredictable due to the size of vegetations and distal embolization.•Early surgery is indicated in complicated staphylococcal tricuspid valve endocarditis, but is associated with substantial risk, including early prosthetic valve endocarditis•Large-bore percutaneous mechanical aspiration provides early source control and limits valve destruction and serves as destination therapy or a bridge to more definitive surgery.