Precision in Action: Using Intracardiac Echocardiography for Targeted Removal of a Large Lead-Related Vegetation in a Patient With Infective Endocarditis

IF 1.7 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Arrhythmia Pub Date : 2025-09-12 DOI:10.1002/joa3.70192

Muhammad Memon, Mohamad Sabra, Arfaat A. Khan

{"title":"Precision in Action: Using Intracardiac Echocardiography for Targeted Removal of a Large Lead-Related Vegetation in a Patient With Infective Endocarditis","authors":"Muhammad Memon, Mohamad Sabra, Arfaat A. Khan","doi":"10.1002/joa3.70192","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>Lead-related infective endocarditis is a serious complication of implantable cardioverter-defibrillators (ICDs), especially in patients with advanced heart failure who are poor surgical candidates. Management of large lead-associated vegetations remains a clinical challenge.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We present the case of a 54-year-old woman with ischemic cardiomyopathy and recurrent ICD complications who developed bacteremia and infective endocarditis with vegetations on the aortic valve and a 1.5 × 1.3 cm mass on the right ventricular lead. Given her poor surgical candidacy due to worsening heart failure, a percutaneous approach was pursued.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The patient underwent successful intracardiac echocardiography (ICE)-guided catheter-based vegetation removal using a vacuum-assisted aspiration system, followed by transvenous lead extraction. The procedure was well tolerated, and the patient demonstrated clinical improvement post intervention.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>This case illustrates the utility of ICE-guided percutaneous aspiration and lead extraction for managing large lead-related vegetations in patients with infective endocarditis who are not candidates for surgery.</p>\n </section>\n </div>","PeriodicalId":15174,"journal":{"name":"Journal of Arrhythmia","volume":"41 5","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/joa3.70192","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Arrhythmia","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/joa3.70192","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Lead-related infective endocarditis is a serious complication of implantable cardioverter-defibrillators (ICDs), especially in patients with advanced heart failure who are poor surgical candidates. Management of large lead-associated vegetations remains a clinical challenge.

Methods

We present the case of a 54-year-old woman with ischemic cardiomyopathy and recurrent ICD complications who developed bacteremia and infective endocarditis with vegetations on the aortic valve and a 1.5 × 1.3 cm mass on the right ventricular lead. Given her poor surgical candidacy due to worsening heart failure, a percutaneous approach was pursued.

Results

The patient underwent successful intracardiac echocardiography (ICE)-guided catheter-based vegetation removal using a vacuum-assisted aspiration system, followed by transvenous lead extraction. The procedure was well tolerated, and the patient demonstrated clinical improvement post intervention.

Conclusions

This case illustrates the utility of ICE-guided percutaneous aspiration and lead extraction for managing large lead-related vegetations in patients with infective endocarditis who are not candidates for surgery.

Abstract Image

查看原文本刊更多论文

精确行动：使用心内超声心动图有针对性地去除感染性心内膜炎患者的大铅相关植被

背景：铅相关的感染性心内膜炎是植入式心律转复除颤器（ICDs）的严重并发症，特别是在不适合手术的晚期心力衰竭患者中。大型铅相关植被的管理仍然是一个临床挑战。方法我们报告一例54岁女性缺血性心肌病和复发性ICD并发症，并发菌血症和感染性心内膜炎，主动脉瓣赘生物和右心室导联1.5 × 1.3 cm肿块。由于心衰恶化，她不适合手术治疗，我们选择了经皮入路。结果患者在超声心动图（ICE）引导下，使用真空辅助吸吸系统成功进行了导管植物清除，随后进行了经静脉铅提取。该手术耐受性良好，患者在干预后表现出临床改善。结论：本病例说明了ice引导下经皮吸铅拔铅对不适合手术治疗的感染性心内膜炎患者处理大面积铅相关植物的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊