Minimally invasive management of bioprosthetic tricuspid valve endocarditis with hemodynamically significant tricuspid stenosis using AngioVac: A case report

We report the case of a 44-year-old male with sepsis secondary to Streptococcus oralis bacteremia complicated by bioprosthetic tricuspid valve endocarditis and severe, symptomatic tricuspid stenosis. Due to significant comorbidities and ongoing polysubstance abuse, initial vegetation debulking using the AngioVac F22 (Angiodynamics NY, USA) mechanical aspiration system was pursued prior to consideration of re-do surgical tricuspid valve replacement. Mechanical aspiration successfully removed the majority of the large valve vegetation, resulting in significantly improved tricuspid valve gradients. This case highlights the AngioVac system's clinical utility in reducing the hemodynamic consequences of large valvular vegetations in high surgical risks patients.