AngioVac Procedures: Integration of cardiac surgeon and anesthesiologist-led transesophageal echocardiography: A preliminary report

Cory Y. Lin; Arun K. Singhal; Nicholas B. Cavanaugh; Sudhakar Subramani; Jarrod K. Bang; Satoshi Hanada

doi:10.1016/j.heliyon.2024.e33225

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AngioVac Procedures: Integration of cardiac surgeon and anesthesiologist-led transesophageal echocardiography: A preliminary report

Journal article

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Peer reviewed

AngioVac Procedures: Integration of cardiac surgeon and anesthesiologist-led transesophageal echocardiography: A preliminary report

Cory Y. Lin, Arun K. Singhal, Nicholas B. Cavanaugh, Sudhakar Subramani, Jarrod K. Bang and Satoshi Hanada

Heliyon, Vol.10(13), e33225

07/15/2024

DOI: 10.1016/j.heliyon.2024.e33225

PMCID: PMC11255581

PMID: 39027608

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Abstract

The AngioVac system is a novel, minimally invasive, endovascular technique used to evacuate intravascular or intracardiac vegetation or thrombus. Although most AngioVac procedures are currently performed by interventionalists, this innovative procedure has been gaining attention among the surgical and anesthesia communities. We retrospectively reviewed all patients who underwent the AngioVac procedure performed by a cardiac surgeon between August 2019 and December 2022. Fellowship-trained cardiac anesthesiologists operated TEE to navigate the AngioVac cannula during the procedure. The stored TEE images were retrospectively reviewed and independently analyzed by two cardiac anesthesiologists with specific focus on TEE-guided navigation of the AngioVac cannula towards the aspiration target. Eleven patients underwent the AngioVac procedure during the study period. In nine cases, the majority of the vegetation or thrombus was successfully aspirated. In two cases, incomplete aspiration was attributed to the mass burden being too large, firm, and chronic in etiology. Worsening tricuspid regurgitation (TR) was identified in three of the 11 cases. Intraoperative TEE provided the cardiac surgeon with simultaneous display of the AngioVac cannula shaft, its tip, and aspiration target, as well as real-time assessment of TR, facilitating the minute movements essential for successful outcomes. This study details our experience and the effectiveness of the AngioVac system for treating soft, intracardiac vegetation or thrombus in a minimally invasive manner. Experienced cardiac anesthesiologists have the skillsets and knowledge to provide optimal live TEE imaging necessary for successful maneuvering of the AngioVac cannula.

AngioVac

Cardiac surgeon

Infective endocarditis

Thrombus

Transesophageal echocardiography

Vegetation

Details

Title: Subtitle: AngioVac Procedures: Integration of cardiac surgeon and anesthesiologist-led transesophageal echocardiography: A preliminary report
Creators: Cory Y. Lin - University of Iowa
Arun K. Singhal - University of Iowa, Carver College of Medicine, Department of Cardiothoracic Surgery, 200 Hawkins Drive, Iowa City, IA 52242, USA
Nicholas B. Cavanaugh - University of Iowa
Sudhakar Subramani - University of Iowa
Jarrod K. Bang - University of Iowa
Satoshi Hanada - University of Iowa, Carver College of Medicine, Department of Anesthesia, 200 Hawkins Drive, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: Heliyon, Vol.10(13), e33225
Publisher: Elsevier Ltd
DOI: 10.1016/j.heliyon.2024.e33225
PMID: 39027608
PMCID: PMC11255581
ISSN: 2405-8440
eISSN: 2405-8440
Language: English
Date published: 07/15/2024
Academic Unit: Anesthesia; Cardiothoracic Surgery
Record Identifier: 9984648573302771

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