TCT-660 Percutaneous Retrieval of Large Mitral Valve Vegetation Using the FlowTriever System with Cerebral Embolic Protection: A Novel Approach in a High-Risk Patient Presenting with Stroke

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Methods: An 83-year-old female with a history of Atrial fibrillation and prior Mitral and Tricuspid valve repair presented with an acute stroke. MRI confirmed new embolic infarcts. TEE revealed a large mobile mitral valve vegetation despite a negative infectious workup. Given the high surgical risk, percutaneous retrieval was pursued. Knowing the hypermobility of this mass, we elected to use a novel method for full-body protection using the ŌNŌCOR device. Results: Under moderate sedation, Access was obtained via the right femoral artery. A TruSteer sheath was advanced over an Amplatz Super Stiff guidewire into the ascending aorta. The ŌNŌCOR retrieval device was deployed at the aortic root through this sheath for embolic protection. Under intracardiac echocardiography guidance, transseptal access was achieved. Following septal balloon dilation, a 24F FlowTriever aspiration catheter was advanced into the left atrium. The vegetation was successfully retrieved via multiple aspiration passes. The ŌNŌCOR retrieval device was retrieved; small debris was captured. The procedure was technically successful, with complete vegetation retrieval. Specimen analysis was negative for endocarditis. Conclusion: Percutaneous transseptal aspiration thrombectomy using the FlowTriever system, combined with the ŌNŌCOR device for full body protection, is a feasible and novel approach for managing large, mitral valve vegetations in high-risk surgical patients. This case demonstrates the potential for catheter-based interventions in complex structural heart disease. Categories: STRUCTURAL: Valvular Disease and Intervention: Mitral

Volume

86

Issue

17

First Page

B287

Last Page

B288

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