TCT-667 Transcatheter Mechanical Vacuum-Assisted Extraction of Cardiac Mass in Systemic Circulation: A Multi-center Collaboration
Recommended Citation
Fang J, Fram G, Frisoli T, Villablanca P, Giustino G, Lee J, Kar Lok Lai L, O'Neill B, Engel Gonzalez P, Wang D, O'Neill W, Eng M. TCT-667 Transcatheter Mechanical Vacuum-Assisted Extraction of Cardiac Mass in Systemic Circulation: A Multi-center Collaboration. J Am Coll Cardiol 2025; 86(17):B290-B291.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Summary: In this multicenter registry, we aim to evaluate the safety and clinical outcomes of transcatheter mechanical vacuum- assisted extraction (TMVE) for intracardiac masses located in the left heart and aortic arch. Specifically, we will assess several factors, including intraprocedural characteristics such as procedural time and hemodynamic effect, procedural success rates, case cancellation and abortion rate, and in-hospital periprocedural and 30-day clinical outcomes in terms of major cardiac structural complications, such as bleeding, vascular complications, hemodynamic instability, stroke, coronary ischemia, and mortality. Additionally, we will evaluate any difference in success rate according to mass type and location and potential damage to left-sided cardiac structures, such as the aortic and mitral valves. We hypothesize that TMVE, as a safe and effective alternative to surgical extraction for high-risk patients unfit for surgical removal of intracardiac masses. Primary aim: To evaluate the procedural safety and success rate of TMVE in the systemic circulation in a multicenter registry Secondary aim: To evaluate the short-to-midterm clinical outcomes of TMVE in the systemic circulation in a multi-center registry. Cardio-embolism caused by large intracardiac and aortic masses is an uncommon yet potentially life-threatening condition. These types of masses can include thrombi, vegetations, atheromas, and cardiac tumors. The consequences of these masses may involve neurologically debilitating or limb-threatening embolic events, obstruction of blood flow leading to hemodynamic compromise and heart failure, and uncontrolled sepsis in cases of infective endocarditis. Indications for mass removal may include an active or recent embolic event, a high risk of embolism, the need for infection control, or the facilitation of concurrent valvular or structural heart procedures, or mechanical circulatory support. While surgical extraction is an effective treatment method, many patients presenting with intracardiac masses may not be suitable candidates for surgery. This may be due to high comorbidity burdens, advanced age or frailty, unfavorable anatomy for open-heart surgery, acute or unstable clinical presentations, or a poor benefit-to-risk ratio for the procedure. Transcatheter mechanical vacuum-assisted extraction (TMVE) using the AngioVAC system (Angiodynamics, New York, USA) has gained popularity for right-sided masses and vegetations both for debulking of mass and for infection control [1, 2]. There has been increasing interest in TMVE of left-sided intracardiac and aortic masses. However, data on left-sided TMVE is scarce. This is a multi-center, retrospective cohort study of all patients who underwent TMVE in the systemic circulation at the participating institutions. The research team from each participating institution will review electronic health records charts to collect relevant data and review pre- and post-procedural images to extract relevant data. The research team will not contact patients who underwent systemic TMVE. A unified data collection spreadsheet including well-defined variables will be used for all participating institutions to ensure the consistency of the data.
Volume
86
Issue
17
First Page
B290
Last Page
B291
