# Repeat AngioVac Debulking of a Large Right Atrial Thrombus With Extension From the Hepatic Vein

## TL;DR

This paper describes a case where the AngioVac system was used twice to remove a large blood clot in a cancer patient with a heart infection.

## Contribution

The novelty lies in the repeat use of AngioVac for debulking a thrombus in a complex clinical scenario involving malignancy and endocarditis.

## Key findings

- The AngioVac system successfully debulked a large right atrial thrombus extending from the hepatic vein.
- Repeat AngioVac use was feasible in a high-risk patient with advanced malignancy and endocarditis.
- The procedure was associated with clinical improvement in the patient's condition.

## Abstract

The AngioVac mechanical aspiration system has emerged in the literature as a viable treatment option for patients with intracardiac masses and thrombi and who are deemed high risk for cardiac surgery. Notably, it has been shown to be an effective treatment modality for the debulking of thrombi in the setting of malignancy. We present a case of repeat AngioVac debulking of a large right atrial thrombus with extension from the hepatic vein in the setting of advanced malignancy complicated by Enterococcus faecium endocarditis.