Percutaneous Multivalvular Endocarditis Debulking With a Whole-Body Embolic Protection Device.

Q4 Medicine

JACC. Case reports Pub Date : 2026-10-20 DOI:10.1016/j.jaccas.2026.110760

Ahmad Younes, Carson Oostra, Robert Roether, Donald Crescenzo, Mohamad Dabaja, Claudiu Georgescu, Stephanie Younes

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引用次数: 0

Abstract

Background: Percutaneous debulking of left-sided endocarditis and thrombus has previously relied on cerebral-only embolic protection devices. The Emboliner is an investigational nitinol-mesh filter that provides whole-body embolic protection and has been studied in transcatheter aortic valve replacement.

Summary: We describe its first reported use as an adjunct to AngioVac-based debulking in 2 patients: 1 with aortic valve endocarditis and 1 with combined tricuspid and mitral endocarditis.

Discussion: The Emboliner was successfully deployed in both cases, with over 90% of vegetation removed and no periprocedural or in-hospital embolic events. Deployment technique differed by vegetation location: in the aortic valve case, the AngioVac cannula was advanced through the filter's access port; in the tricuspid/mitral case, no further interaction with the filter was required once deployed.

Novelty: This represents, to our knowledge, the first reported use of whole-body embolic protection during aortic and combined tricuspid/mitral percutaneous endocarditis debulking.

Take-home message: Whole-body embolic protection may offer an important adjunct to percutaneous debulking in patients at high surgical risk.

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采用全身栓塞保护装置的经皮多瓣心内膜炎消肿。

背景：左侧心内膜炎和血栓的经皮减压以前依赖于仅脑栓塞保护装置。栓塞器是一种试验性镍钛醇网过滤器，可提供全身栓塞保护，并已在经导管主动脉瓣置换术中进行了研究。摘要：我们首次报道了在2例患者中作为血管腔内腔减压术的辅助治疗：1例主动脉瓣心内膜炎患者和1例合并三尖瓣和二尖瓣心内膜炎患者。讨论：栓塞器在这两个病例中都成功部署，超过90%的植被被清除，没有围手术期或院内栓塞事件。不同植被位置的部署技术不同：在主动脉瓣病例中，AngioVac套管通过过滤器的通路口推进；在三尖瓣/二尖瓣情况下，一旦部署，不需要与过滤器进一步相互作用。新颖性：据我们所知，这是首次报道在主动脉和合并三尖瓣/二尖瓣经皮心内膜炎降压过程中使用全身栓塞保护。关键信息：对于手术风险高的患者，全身栓塞保护可能是经皮减压的重要辅助手段。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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