Abstract
The AngioVac System (AngioDynamics, Inc) is currently approved for the removal of right-sided venous thrombi and emboli.1 This case highlights its off-label use in the extraction of large pulmonic valve vegetation. The patient was a chronically ill 45-year-old man with a past medical history of chronic systolic heart failure with reduced ejection fraction (left ventricular ejection fraction, 30%-35%) from nonischemic cardiomyopathy, chronic hypoxic respiratory failure (2 L nasal cannula oxygen at baseline), chronic kidney disease (stage IIIb), severe pulmonary hypertension (mean resting pulmonary artery pressure, 60 mm Hg), recurrent episodes of bacteremia with right-sided infective endocarditis from intravenous drug use, and medical noncompliance.
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