Percutaneous Mechanical Aspiration of Bioprosthetic Tricuspid Valve Vegetation and Thrombi in Drug Use-Associated Infective Endocarditis

Bioprosthetic Tricuspid Valve Vegetation and Thrombi in Drug Use-Associated Infective EndocarditisA 27-year-old male with a history of intravenous drug use presented with recurrent fungal prosthetic tricuspid valve endocarditis and septic emboli, six months after a prior bioprosthetic valve replacement for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE).Given high surgical risk, he underwent percutaneous mechanical aspiration (PMA) of the valve vegetation and right atrial thrombi using a Penumbra 16F catheter system.PMA was well tolerated, achieved a >50% reduction in vegetation burden, and modest improvement to transvalvular gradient (11 to 6 mmHg).This case supports expanding PMA applications in high-risk drug use-associated infective endocarditis.