Clinical Conversation: Percutaneous Mechanical Aspiration for Infective Endocarditis-Manuscript: Percutaneous Mechanical Aspiration for Infective Endocarditis: Proceedings From an Inaugural Multidisciplinary Summit and Comprehensive Review

Manuscript: Percutaneous Mechanical Aspiration for Infective Endocarditis: Proceedings From an Inaugural Multidisciplinary Summit and Comprehensive Review

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The document provides a comprehensive summary of the inaugural multidisciplinary summit on Percutaneous Mechanical Aspiration (PMA) for infective endocarditis (IE). It highlights discussions among experts from various disciplines about the evolving role of PMA as a treatment for endocarditis, suggesting it as a complementary intervention alongside traditional treatments like antibiotics and surgery.<br /><br />PMA, which involves the transcatheter-based removal of infected material from the heart, is proposed for three primary clinical roles: as a bridge to decision-making regarding surgery, as a destination therapy for patients who cannot undergo surgery, and as an adjunctive therapy to minimize risks, especially before interventions like transvenous lead extractions.<br /><br />The report identifies two main patient groups for PMA consideration: elderly patients with chronic cardiac devices, who might be at high surgical risk, and younger individuals with drug use-associated IE (DUA-IE), who are also at elevated surgical risk and may experience poor outcomes due to ongoing substance use disorder (SUD). For these groups, PMA could potentially reduce risks associated with surgery or serve as an interim measure allowing time for SUD stabilization before making surgical decisions.<br /><br />The summit acknowledged the promise of PMA but also identified significant gaps in the evidence base. While observational data suggest low complication rates, there is a need for more robust research, including prospective and randomized studies, to better understand the safety and effectiveness of PMA.<br /><br />A key outcome of the summit was the proposal to form a national consortium to coordinate research efforts, set best practices, and ensure equitable access to PMA. This would include addressing financial considerations, improving clinical collaboration, and standardizing documentation and coding to facilitate reimbursement and claims-based research.<br /><br />The report emphasizes the importance of interdisciplinary collaboration and comprehensive research to realize PMA's full potential in improving outcomes for patients with modern endocarditis.

Keywords

Percutaneous Mechanical Aspiration

infective endocarditis

multidisciplinary summit

treatment

clinical roles

surgical risk

drug use-associated IE

substance use disorder

national consortium

interdisciplinary collaboration