OR13-5
Outcomes of Angiovac for Right Sided Infective Endocarditis
Presenter
Santul Bapat, MD, Wake Forest Baptist Health, Winston Salem, NC
Santul Bapat, MD, Wake Forest Baptist Health, Winston Salem, NC, Carriel Taylor Nipp, MD, Wake Forest Baptist Health, Winston-Salem, NC, P. Matthew Matthew Belford, M.D., FSCAI, Wake Forest Baptist Health, Clemmons, NC and David X. Zhao, M.D., FSCAI, Wake Forest School of Medicine, Winston Salem, NC
Keywords: TTVR/Tricuspid Valve
Background
Right-sided infective endocarditis (RSIE) is a condition with high morbidity and mortality. Traditionally, treatment has consisted of valve replacement therapy and/or prolonged courses of intravenous antibiotics. AngioVac-assisted vegetation debulking (AVD) is a relatively new treatment which has potential to improve outcomes for patients with RSIE.
Methods
We retrospectively identified 43 patients with RSIE and confirmed history of IV drug use who were treated with AVD at a single tertiary center between 2015 and 2023. Peri-procedural and post-discharge outcomes were analyzed.
Results
We included 43 patients who were treated at out academic medical center. All patients had confirmed history of IV drug use and imaging/cultures consistent with right sided endocarditis. Included patients had average age of 35 ± 8.5. 37% of patients were male. 88% of patients were non-Hispanic White. The implicated organism was MSSA in 49% of cases, MRSA in 35% of cases, and other organisms in 16% of cases. 67% of patients had moderate or severe tricuspid regurgitation. Mean vegetation size across the largest dimension was 2.4 ± 0.9cm. Mean length of stay was 27.6 ± 19 days. Time to defervescence was 5.9 ± 5.1 days; time to clearance of cultures after procedure was 2.4 days. Mortality at 1 year was 12%. Readmission rate within the first year was 21%. The most common complication was worsening septic pulmonary emboli which occurred in 16% of patients. None of the patients in our cohort had a peri-procedural stroke.
Conclusions
AVD has the potential to improve outcomes for patients with RSIE. Further prospective randomized trials are needed to evaluate the efficacy of this procedure and determine which patient populations are most likely to benefit.