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Heart Team Approach for Percutaneous Extraction of Intracardiac Vegetation
Huzaifa Shakir MD FACS, Ajab Shakir.
Rutgers University, Newark, NJ, USA.

Abstract Submission Objective: To describe a unique collaborative team approach and technique in the utilization of a percutaneous device for extraction of intracardiac vegetations and brief review of such approaches in the literature.Methods: We instituted a protocol for use of a percutaneous device by early establishment of team members and roles at a busy Level 1 Trauma center in the New York Metropolitan area with variable provider coverage from outside institutions. We decided that this therapy would be best utilized by interventional cardiologists (IC) and cardiac surgeons. The cardiac surgeon performs groin cannulation and the IC places the extraction cannula/device through the neck or groin depending on optimal anatomy and also assists with transesophageal echocardiography. The cardiac surgeon is responsible for extracorporeal circuit management and decannulation as well as standby for possible cardiac perforation.Results: To date, we have successfully treated 5 patients who presented with tricuspid vegetations and evidence of sepsis and or valve incompetence. All patients were discharged and were alive at 6 months follow up.Conclusions: The establishment of a heart team approach with identification of key personnel responsible for the procedure results in a successful patient outcome and overall program management.


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