NYMC Faculty Publications
Transcatheter Vacuum-Assisted Mass Extraction on a Mitral Bioprosthesis
Author Type(s)
Faculty
DOI
10.1016/j.jaccas.2024.103084
Journal Title
JACC Case Reports
Document Type
Article
Publication Date
3-5-2025
Department
Medicine
Second Department
Surgery
Keywords
echocardiography, imaging, mitral valve
Disciplines
Medicine and Health Sciences
Abstract
An 84-year-old woman with a history of mitral valve replacement, ascending aorta replacement, and pacemaker implantation presented with malaise and progressive shortness of breath. Transthoracic echocardiography and transesophageal echocardiography revealed a left ventricular ejection fraction of 10% to 15% and a floating mass on the mitral prosthesis. She was suspected to have bioprosthetic endocarditis, despite being afebrile and having negative blood cultures. Reoperative mitral valve replacement was considered but deemed too high risk, and a transseptal aspiration of a mass was performed to mitigate systemic embolization risk. Postprocedural transesophageal echocardiography showed no residual mass and a well-functioning bioprosthesis. The pathologic examination revealed extensive fibrin accompanied by inflammation and a fibroblastic reaction. Vacuum-assisted aspiration using the AngioVac has been well described for right-sided intracardiac structure, but left-sided mass extraction has rarely been reported. This successful case illustrates a transcatheter treatment option in an otherwise inoperable patient.
Recommended Citation
Amar, G., Patail, H., Spevack, D., Haidry, S., Agarwal, A., Lansman, S., Ohira, S., Spielvogel, D., Ahmad, H., & Shimamura, J. (2025). Transcatheter Vacuum-Assisted Mass Extraction on a Mitral Bioprosthesis. JACC Case Reports, 30 (5). https://doi.org/10.1016/j.jaccas.2024.103084
