Percutaneous extraction of right atrial mass using the Angiovac aspiration system.

摘要

Fresh fibrin thrombus is deposited on permanent pacemaker leads soon after implantation and eventually becomes organized along its entire length (1). This fibrin sleeve ultimately evolves into a stable cellular-collagen tissue covered by endothelium (1). Fibrin sheath formation is well described with central venous catheters and can become colonized with bacteria in catheter-related infections (2). Treatment of pacemaker and implantable cardioverter-de-fibrillator (ICD) lead infections generally requires prolonged antibiotic therapy, complete hardware removal, and a hardware-free interval (3). Although we are aware of no reports describing the removal of large fibrin sheaths in the setting of infective endocarditis, this would generally require open surgical excision. Here we report a- case of an infected fibrin sheath removed with the use of a novel catheter-based device. The institutional review board at our institution does not require approval for case reports such as this.