Doctors at Mayo Clinic used a new catheter-based approach to draw out resistant pockets of infection that settle in the heart, known as right-sided infective endocarditis, without surgery. Unless treated quickly, the walled-off infections can grow, severely damaging heart valves and potentially affecting other organs as well. In a recent study, over 90% of the participants had their infection cleared, and they had lower in-hospital mortality compared to those whose infections remained.
The research is part of a Mayo Clinic-led study across 19 U.S. sites involving patients who were not good candidates for surgery and whose right-sided heart infections had not responded to antibiotics. Abdallah El Sabbagh, M.D., an interventional cardiologist at Mayo Clinic in Jacksonville, Florida, was the study's principal investigator. Dr. El Sabbagh presented late-breaking research findings at the Transcatheter Cardiovascular Therapeutics Symposium on Oct. 30.
High-risk patients have few treatment options when a serious infection becomes entrenched in a heart valve. People with weakened immune systems, such as those who have had a transplant or cancer treatment, are more susceptible to such infections. IV drug users and patients with implanted medical devices such as pacemakers and artificial heart valves are also more likely to develop infective endocarditis. Approximately half of the 285 study participants were people who inject IV drugs.
"Our research findings show that using a catheter to draw out most of the heart infection potentially made a significant difference in a patient's response to antibiotic therapy afterward to clear up the infection. The participants in this study were all high-risk patients, and most were not responding to antibiotic therapy alone and were considered to have significant risks with open heart surgery. We were able to show that minimally invasive catheter-based aspiration of the infection is feasible, successful and may help a significant population of patients who otherwise have no alternative therapeutic options," says Dr. El Sabbagh.
The catheter-based system was originally developed to remove blood clots from the lungs without surgery. While its off-label use for infective endocarditis shows potential as a safe and effective option, Dr. El Sabbagh notes that further prospective study is needed.
