Journal of Medical Cases, ISSN 1923-4155 print, 1923-4163 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Med Cases and Elmer Press Inc
Journal website https://www.journalmc.org

Case Report

Volume 14, Number 11, November 2023, pages 362-368

Percutaneous Intracardiac Mass Extraction in High Surgical-Risk Patients

Figures

Figure 1.
Figure 1. Electrocardiogram at time of presentation to the emergency department.
Figure 2.
Figure 2. Transthoracic echocardiogram showing the large right atrial echodensity (arrow) protruding through the tricuspid valve.
Figure 3.
Figure 3. Components of the Penumbra Lightning 12 Intelligent Aspiration System used in our case.
Figure 4.
Figure 4. Right atrial mass (Candida vegetation) gross appearance. The green arrow shows the body of the mass, while the blue arrow shows the stalk.
Figure 5.
Figure 5. Follow-up transthoracic echocardiogram showing resolution of the right atrial mass (arrow) following percutaneous extraction.

Table

Table 1. Comparison of the AngioVac, Penumbra and Inari Systems
 
DeviceAspiration usesContraindicationsAdvantagesDisadvantages
ECMO: extracorporeal membrane oxygenation; IVC: inferior vena cava; v-v: veno-venous.
AngioVac systemIntracardiac masses; Pulmonary emboliSevere vascular disease; Chronic thrombi or adherent massesMinimal blood loss (blood is returned through v-v ECMO)ECMO causes increased procedural time and cost
Penumbra Lightning Aspiration SystemIntracardiac masses; Pulmonary emboli; Peripheral thrombiPre-existing vascular injuriesECMO not requiredBlood loss is expected during the procedure
Inari Medical Device SystemPulmonary emboli; Venous thrombiIVC filter or venous stents; Small vesselsECMO not requiredThrombus can be dislodged