Fighting fungus with a laser and a hose: Management of a giant Candida albicans implantable cardioverter‐defibrillator lead vegetation with simultaneous AngioVac aspiration and laser sheath lead extraction. Issue 2 (19th July 2017)

• Record Type: Journal Article
• Authors: Jones, Brandon M.; Wazni, Oussama; Rehm, Susan J.; Shishehbor, Mehdi H.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 91:Issue 2(2018)
• Page Start: 318
• Page End: 321
• Publication Date: 2017-07-19
• Subjects: endocarditis -- endovascular intervention -- foreign body retrieval -- lead extraction -- thrombectomy -- laser; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.27153
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Infections involving internal cardiac devices can be very challenging to treat, and almost universally require complete device extraction for successful management. Of the pathogens that cause device‐related endocarditis, fungi such as Candida albicans are notoriously difficult to manage because of their propensity to produce large vegetations and the need for long‐term treatment with potentially toxic medications. Furthermore, individuals who develop fungal, device‐associated endocarditis are typically among the most complex patients, with significant comorbidities that place them at high risk for open heart procedures such as surgical device extraction. We present a case of one such patient in whom treatment of Candida albicans device‐related endocarditis was managed using AngioVac ® aspiration of a large right atrial vegetation with simultaneous laser sheath extraction of the implantable cardioverter‐defibrillator lead.