Table 1.
Reports on the use of the AngioVac device in treatment of RSIE.
| Author/year | Type of publication | Age/sex | Organism | Location of vegetation | Indication for procedure | Preprocedural vegetation size | Reduction in vegetation size | Postprocedural bacteremia | Tricuspid regurgitation (TR) progression | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Todoran et al. [20] (2011) | Case report | 53 y/o, M | Haemophilus parainfluenzae | SVC/RA junction | Lack of response to appropriate antimicrobial therapy | 1.7 cm | 100% removal | Resolved | Not reported | Improvement with no further sequel |
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| Jones et al. [21] (2017) | Case report | 25 y/o, F | Candida albicans | (i) SV/RA junction attached to ICD RV lead | (i) Persistent fungemia despite appropriate antimicrobial therapy | SV/RA junction: 6.1 cm × 1.65 cm | Removal of 6 cm vegetation (residual vegetation size not reported) | Resolved | Not reported | Improvement with no further sequel |
| (ii) RA | (ii) Recurrent septic emboli | RA: −2.1 cm × 1.6 cm | ||||||||
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| Schaerf et al. [10] (2016) | Retrospective study (20 patients) | Mean age: 76 ± 11 | 8 coagulase-negative SA | 13 ICD; 7 pacemaker | (i) Lack of response to appropriate antimicrobial therapy | Average size: 3.6 cm ± 1.2 cm | Not mentioned | Resolved in 19/20 patients | Not reported | Not reported clearly |
| 3 MSSA | ||||||||||
| 4 MRSA | ||||||||||
| 3 Streptococci | ||||||||||
| Sex not reported | ||||||||||
| 1 Enterococcus | ||||||||||
| 1 Polymicrobial | ||||||||||
| (ii) Bridge to percutaneous lead removal | ||||||||||
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| ||||||||||
| Thiagaraj et al. [22] (2017) | Case series | Patient 1: 35 y/o, M | MSSA | SVC/RA junction extending into TV | (i) Lack of response to appropriate antimicrobial therapy | 4.5 cm | 100% removal | Resolved | Not reported | Improvement with no further sequel |
| (ii) Vegetation size ≥ 20 mm | ||||||||||
| Patient 2: 28 y/o, F | MRSA | TV | (i) Lack of response to appropriate antimicrobial therapy | 2.2 × 1.7 cm | 100% removal | Resolved | Not reported | MRSA bacteremia recurrence, cardiac arrest, and death 5 days post procedure | ||
| (ii) Vegetation size ≥ 20 mm | ||||||||||
| Patient 3: 53 y/o, F | Enterococcus faecalis | Bioprosthetic TV | (i) Vegetation size ≥ 20 mm | 3.2 cm | 25–50% reduction in size | Resolved | Improvement from moderate to mild | Improvement with mild worsening of TR | ||
| (ii) Worsening of TV regurgitation | ||||||||||
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| Divekar et al. [7] (2013) | Case report | 17 y/o, M | MSSA | Pulmonary valve | Recurrent pulmonary embolism despite antimicrobial therapy | 3.5 cm × 1.5 cm | Significant reduction (residual vegetation size not reported) | Resolved | Not reported | Clinical improvement with no further sequel |
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| George et al. [23] (2017) | Retrospective study (33 patients) | Mean age: 37 ± 12 | 14 MRSA | TV | Lack of response to appropriate antimicrobial therapy | 2.1 cm ± 0.7 cm | Average of 61% reduction in size | Resolved in 28/33 patients | 14 patients: worsening of TR (3 required elective TV repair) | 28 patients: improvement with no further sequel |
| 11 MSSA | ||||||||||
| 12, M | 3 polymicrobial | 1 patient: developed postprocedural cardiac tamponade requiring pericardiocentesis | ||||||||
| 21, F | 5 Candida | 3 patients: death | ||||||||
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| Makdisi et al. [16] (2016) | Case report | 24 y/o, M | MRSA | TV | Lack of response to appropriate antimicrobial therapy | 0.9 cm × 0.7 cm | 80% reduction in size | Resolved | No change | Clinical improvement with no further sequel |
| 0.7 cm × 1 cm | ||||||||||
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| Patel et al. [11] (2013) | Case series | Patient 1: 59 y/o, M | SA | ICD lead | (i) Vegetation size ≥ 20 mm | 3 cm × 2 cm | Significant reduction (residual vegetation size not reported) | Resolved | Improvement in degree of TR | Clinical improvement with no further sequel |
| (ii) Bridge to percutaneous lead removal | ||||||||||
| Patient 2: 82 y/o, M | Group B Streptococcus | (i) Pacemaker lead | (i) Vegetation size ≥ 20 mm | (i) Pacemaker lead: 4 cm × 1.5 cm | Significant reduction (residual vegetation size not reported) | Not reported | Not reported | Not reported | ||
| (ii) TV | (ii) Bridge to percutaneous lead removal | (ii) TV: 0.5 cm × 1.1 cm | ||||||||
| Patient 3: 56 y/o, F | MRSA | Pacemaker lead | (i) Vegetation size ≥ 20 mm | 3.5 cm × 1.7 cm | Significant reduction (residual vegetation size not reported) | Persistent bacteremia | Worsening of TR | Formation of new vegetation with severe TR that required TV repair | ||
| (ii) Bridge to percutaneous lead removal | ||||||||||
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| Dalia et al. [12] (2016) | Case report | 26 y/o, F | Not reported | TV | Bridge to pulmonary artery aneurysm repair | 1.6 cm × 0.8 cm | Significant reduction (residual vegetation size not reported) | Not reported | Not reported | Underwent pulmonary artery aneurysm repair successfully; clinical improvement with no further sequel |
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| Hosoba et al. [24] (2015) | Case series | Patient 1: 67 y/o, F | MRSA | RA | Not reported | 1.5 cm × 1.5 cm | Not reported | Resolved | Not reported | Clinical improvement with no further sequel |
| Patient 2: 33 y/o, M | Enterobacter cloacae | RA near Chiari network | Not reported | 2.2 cm × 0.6 cm | Not reported | Resolved | Not reported | Clinical improvement with no further sequel | ||
| Patient 3: 70 y/o, M | MSSA | SVC/RA junction | Vegetation size 20 mm | 3.4 cm × 1.3 cm | Not reported | Resolved | Not reported | Clinical improvement with no further sequel | ||
M: male, F: female, y/o: years old, SVC: superior vena cava, RA: right atrium, ICD: implantable cardioverter defibrillator, RV: right ventricle, SA: Staphylococcus aureus, MSSA: methicillin-sensitive Staphylococcus aureus, MRSA: methicillin-resistant Staphylococcus aureus, TV: tricuspid valve, TR: tricuspid regurgitation.