{"title":"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","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":"{\"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}","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}
Precision in Action: Using Intracardiac Echocardiography for Targeted Removal of a Large Lead-Related Vegetation in a Patient With Infective Endocarditis
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
