Management of Right-Sided Cardiac Masses With Manual Aspiration Using AlphaVac Device: A Single-Center Case Series

TL;DR

This case series explores using the AlphaVac device to manage heart masses in high-risk patients who cannot undergo surgery.

Contribution

The study presents a novel application of the AlphaVac system for treating right-sided cardiac masses in surgical high-risk patients.

Findings

AlphaVac successfully debulked masses in four patients, enabling stabilization or antimicrobial therapy.

One patient required valvular replacement after complications from aortic valve endocarditis.

One patient died due to severe comorbidities and persistent infection despite aspiration.

Abstract

Right-sided cardiac masses pose therapeutic challenges, particularly in patients at high surgical risk. The AlphaVac mechanical aspiration system (AngioDynamics) provides a minimally invasive, endovascular alternative to surgery or AngioVac (AngioDynamics). We report 6 consecutive patients managed with AlphaVac, all deemed poor surgical candidates by a multidisciplinary heart team. One patient died from severe comorbidities and persistent fungemia despite aspiration. Four achieved sufficient debulking, allowing stabilization or definitive antimicrobial therapy when infected. One required transfer for valvular replacement due to aortic valve endocarditis with perforation and systemic embolism. AlphaVac enabled effective aspiration in high-risk patients unsuitable for immediate surgical intervention.

Figures