TCT-662 Percutaneous Mechanical Aspiration for Right-Sided Infective Endocarditis in People Who Inject Drugs and Those with Cardiovascular Implantable Electronic Devices: Insights From the CLEAR-IE Multicenter Registry
Recommended Citation
Heybati K, El Sabbagh A, Hibbert B, Bangalore S, Fong P, Zlotnick D, El-Sabawi B, Zhang R, Zwischenberger B, Mourad A, Palatnic L, Sayfo S, Gilyard S, Younes S, Younes A, Ingrassia J, Cheema M, Hammadah M, Prasad A, Hamid N, Voudris K, Villablanca P, Kaki A, Qintar M, Baloch ZQ, Klein A, Yadav P, Patton M, Dominguez A, Panaich S. TCT-662 Percutaneous Mechanical Aspiration for Right-Sided Infective Endocarditis in People Who Inject Drugs and Those with Cardiovascular Implantable Electronic Devices: Insights From the CLEAR-IE Multicenter Registry. J Am Coll Cardiol 2025; 86(17):B288-B289.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: Percutaneous mechanical aspiration (PMA) has emerged as a therapeutic option for right-sided infective endocarditis (RSIE). Existing data originate from diverse populations, and comparative characteristics and outcomes between people who inject drugs (PWID) and patients with cardiac implantable electronic devices (CIED) are unclear. Methods: This was an analysis from CLEAR-IE (Cardiac Lesion Extraction and Aspiration Registry for Infective Endocarditis), a registry of adults with RSIE who underwent PMA at 19 US centers between 01/2014 and 01/2024. Patients were stratified into either the PWID or CIED group. The primary outcome was procedural success, defined as ≥70% reduction in vegetation size or residual vegetation <10 mm. Secondary outcomes included a composite of in-hospital death, new pulmonary embolism (PE), or emergency surgery. Data were summarized using descriptive statistics with complete case analysis. Results: Of 182 patients, 122 (67.0%) were PWID and 60 (33.0%) had CIED. PWID were significantly younger (36 vs 65 years; P<0.001), had fewer comorbidities, and more frequently had prior infective endocarditis (28.7% vs 5.8%; P<0.001). PWID exhibited higher rates of septic PE (80.3% vs 11.7%; P<0.001), hypoxia at presentation (41.0% vs 25.0%; P=0.034), and persistent sepsis despite antibiotics (77.9% vs 41.7%; P<0.001). Staphylococcus species were more common in PWID (88.3% vs 49.2%; P<0.001). Vegetation sizes were similar (26.5 vs 23.0 mm; P=0.35). Continuous-flow aspiration was more frequently used in PWID (93.9% vs 63.8%; P<0.001). Procedural success was achieved in 84.3% and 96.5% of patients in the PWID and CIED groups, respectively. Secondary outcome rate was 18.0% and 23.3% in the PWID and CIED groups, respectively. Self-directed discharge occurred primarily among PWID (15.8% vs 0.0%; P=0.003). Of those with follow-up at 6-weeks (N=151), overall mortality was 9.3% (9/97) and 18.5% (10/54) in the PWID and CIED groups, respectively. Conclusion: PWID and CIED subgroups with RSIE demonstrate distinct clinical profiles and outcomes following PMA. These findings underscore the importance of subgroup-specific evaluation and tailored risk stratification in future prospective studies. Categories: STRUCTURAL: Valvular Disease and Intervention: Tricuspid
Volume
86
Issue
17
First Page
B288
Last Page
B289
