Search Results for: Linee Guida per le cure post-parto

Circulation, Volume 150, Issue Suppl_1, Page A4131100-A4131100, November 12, 2024. Background:Previous literature shows that metabolic surgery effectively decreases the risk of cardiovascular disease (CVD) events in patients with obesity. The use of metabolic surgery has, however, been limited in people with obesity and pre-existing CVD due to concerns of poor post-operative cardiovascular outcomes. This study aims to determine the effectiveness and safety of metabolic surgery in patients with pre-existing CVD.Methods:A search of electronic databases, PubMed, Cochrane Central and SCOPUS was conducted from their inception till May 2024. The study was conducted adhering to the PRISMA guidelines. Outcomes of interest were risk of all-cause mortality, major adverse cardiovascular events (MACE), risk of myocardial infarction (MI), and cerebrovascular events in patients with and without prior CVD undergoing bariatric surgery. Data was pooled as generic inverse variance using a random effects model, and presented as hazard ratios (HR) with their 95% confidence intervals (CI).Results:We included four studies in our analysis (n = 5,244). Our pooled analysis shows that metabolic surgery leads to significant reduction in risk of all-cause mortality (HR = 0.51, 95% CI: [0.42, 0.61]; p

Circulation, Volume 150, Issue Suppl_1, Page A4133040-A4133040, November 12, 2024. Introduction:Heart failure (HF) is associated with high mortality and morbidity, and there are limited therapeutic options available to improve cardiac muscle function. Recent studies suggest that the impairment of cardiomyocyte T-tubule microdomains is a key factor in HF pathophysiology. AAV9-cBIN1 gene therapy effectively addresses this impairment. However, the kinetics and biodistribution of AAV9-cBIN1 have not been explored, limiting the knowledge of the transcription efficiency and organ specificity of cBIN1 gene therapy when delivered systemically.Aim:This study aims to elucidate the kinetics and biodistribution of AAV9-cBIN1 in a murine model.Method:Adult male C57BL/6J mice (n=20) were administered a single retro-orbital injection of AAV9-CMV-cBIN1-V5 at a dose (2×10^12 vg/kg) known to effectively transduce the majority of cardiomyocytes. Mice were sacrificed at pre-determined time points: prior to injection (Day 0, n=2) and post-injection at Days 3, 7, 14, 28, 56, and 84 (n=3/group). Tissues were harvested from the heart, lung, liver, kidney, skeletal muscle, and spleen. Genomic DNA was extracted and analyzed using qPCR to determine vector genome (vg) copies. For transcriptional analysis of the AAV9-transduced exogenous gene, mRNA was extracted and converted to cDNA for qRT-PCR quantification ofcBin1-V5, normalized to the housekeeping geneHprt1.Results:All mice survived to their designated sacrifice times. Kinetic analysis demonstrated a time-dependent expression of the exogenouscBin1-V5gene, with peak expression observed at 4 weeks in both the heart and liver, with expression declining in the liver after this peak (Figure 1A). Genomic DNA analysis showed a gradual increase and plateau of viral genome distribution in the heart between 2-4 weeks, while in the liver, distribution peaked sharply between Days 3-7 and then decreased. When correcting the gene transcription ofcBin1-V5(ΔCq ofV5/Hprt1) for vector DNA vg copies in the tissue, the transcription efficiency in the heart was higher than in the liver (Figure 1B). Outside of the liver and heart,cBin1-V5mRNA expression was undetectable in all other tissues by Day 56.Conclusion:In adult male mice, a single systemic administration of AAV9-cBIN1 results in robust transduction and higher transcription efficiency in the heart compared to the liver. AAV9-cBIN1 holds promise for targeted gene therapy in cardiac tissues, with minimal off-target expression in other organs.

Circulation, Volume 150, Issue Suppl_1, Page A4145275-A4145275, November 12, 2024. Introduction:Pre-transplant pulmonary hypertension (PH) increases the risk of post-heart transplant right ventricular failure and as a result, morbidity, and mortality. Irreversible pulmonary hypertension is a contraindication to heart-only transplantation. Invasive and non-invasive methods to show PH reversibility include temporary and durable mechanical circulatory support (MCS), pulmonary vasodilators, diuretics, and inotropes. We herein describe a novel bedside technique to show PH reversibility and discuss its potential implications.Case:A 58-year-old female with advanced nonischemic cardiomyopathy was evaluated for heart transplant. There was no history of diabetes or dysautonomia. Supine right heart catheterization showed significant PH with the following data: PA 70/37 mmHg (48 mmHg); PCWP 25 mmHg; CO 4.03 L/min; PVR 5.7 WU. Diuretic therapy and sodium nitroprusside (SNP) were started, however due to hypotension SNP was stopped, and milrinone was initiated. Incidentally, we noticed that while seated in a chair her pulmonary hemodynamics dramatically improved without additional intervention: BP 111/73 (85) mmHg; PA 36/20 (25 mmHg); CO 3.91L/min. Once back in the supine position, the PA pressures returned to baseline. The findings were reproducible (Figure).Management:The patient continued IV diuretic and milrinone. SNP was not reintroduced, and IABP unloading was avoided as we felt reassured that the postural change in PA pressure was equivalent to vasodilator associated PH reversibility and identified a favorable phenotype for transplant. The patient underwent heart transplant and did not require an RVAD, or prolonged inotrope wean.Conclusion:To our knowledge this is the first case to describe the utility and predictive value of postural reversibility in PH in heart transplant. This is a simple bedside technique that can be performed at no extra cost using gravity to change cardiac loading conditions and may be as effective as more expensive and invasive treatments. Implications include the use of lower body negative pressure (LBNP) to prevent PH while supine during sleep or in bed. LBNP decreases venous return, leading to reduced preload and afterload, and thus reduces PH and in theory may avoid the need for durable MCS to treat PH in those needing heart transplant. We encourage further studies to determine the cost-effectiveness, clinical utility, and predictability of this novel technique for both RV failure post heart transplant and post-LVAD.

Circulation, Volume 150, Issue Suppl_1, Page A4136822-A4136822, November 12, 2024. Amputation is a devastating complication of diabetes and peripheral artery disease and a marker for health inequity. Implementation Science (IS) and Community Engaged-Research (CenR) allow for real-world adaptation of evidence-based interventions and provide critical frameworks for reproducibility and sustainability. However, few amputation interventions use these approaches. We describe the feasibility and acceptability of an IS and CEnR driven amputation intervention in a high-risk rural community.A Pre-Post mixed methods design was used (Fig 1). Intervention components were mapped to the Social-Ecological Model (Fig 2) and guided by the CFIR. Community and Project Advisory Boards collaborated on needs assessment, mobilizing resources, intervention adaptation, data review and dissemination. A 3-component intervention was implemented in 2 clinics to improve local foot care. Components included diabetic foot exams (DFEs), a multidisciplinary limb preservation team, and a “hot-foot” hotline. Pre-implementation, a retrospective chart review was performed along with focus groups. DFE training was then conducted at each site. After training, a prospective chart review was performed with clinic check-ins for 12 months. Focus groups were held 6- and 12-months post-implementation. Concurrently, monthly multidisciplinary teleconferences were held, and a “hot-foot” phoneline connected providers to specialty nurses.At baseline, 155/224 (69.2%) patients received an annual DFE, 17% had all four exam components, 15.6% had foot abnormalities identified and 3.6% were referred to specialists. At 12-months 212/268 (79.1%) patients received a DFE, 84.7% had all components, 54.9% had abnormalities and 20.1% were referred. All findings were statistically significant. Clinically there was a significant decrease in patients with foot wounds, infection, and foot-related hospitalization/ED visits. There were no changes in amputations. (Table 1) The virtual teleconference completed 12 sessions. The hotline was used once with clinicians reporting they did not need it.We demonstrate successful, sustained implementation of an amputation prevention intervention in a high-risk rural community using IS and CEnR. This approach was crucial for overcoming barriers to intervention implementation in a resource poor environment. Additional research to assess patient experience, understand key components of the intervention and study scalability and clinical effectiveness is planned.

Circulation, Volume 150, Issue Suppl_1, Page A4145174-A4145174, November 12, 2024. Background:Protein half-life and turnover are crucial for cellular function, especially under basal and stress conditions, often contributing to proteinopathies. While the impact of oxidative stress (OxS) on proteostasis is well-documented, the role of reductive stress, an overabundance of antioxidant status, in proteotoxic cardiac disease remains elusive.Hypothesis:Tested whether chronic reductive stress (cRS) impairs protein turnover and induce proteotoxic cardiac disease.Methods:In transgenic mice expressing constitutively active Nrf2 (caNrf2-TG) and non-transgenic controls (n=6/gp.), we examined the half-life and turnover rates of the myocardial proteome using D2O labeling and mass spectrometry.Results:We observed significant changes in the half-life of over 1,700 proteins, with approximately 1,200 proteins exhibiting increased half-life at 3 months, despite no noticeable defects in cardiac structure and function. Under OxS induced by isoproterenol (ISO), about 700 proteins showed reduced half-life, underscoring distinct regulatory mechanisms in protein turnover between cRS and OxS. Proteins with altered half-lives were involved in key cellular functions, including metabolism, signal transduction, immune response, transport, and cell cycle regulation under cRS, revealing novel targets undetected in an OxS context. Notably, distinct positive adaptive compensatory (59; p

Circulation, Volume 150, Issue Suppl_1, Page A4117834-A4117834, November 12, 2024. Background:Cardiovascular disease is a leading cause of postoperative morbidity and mortality following liver transplantation (LT). Presence of abdominal aortic calcification (AAC) has been linked to cardiovascular events in the general population. We investigated whether AAC on pre-transplant computed tomography (CT) predicts major adverse cardiovascular events (MACE) post-LT.Methods:Consecutive LT patients between 2010-2018 from the Victorian Liver Transplant Unit (Australia) were included. Extent of AAC was quantified in a blinded fashion, with high AAC defined as a calcium score of ≥500. MACE was defined as any recorded episodes of acute coronary syndrome (ACS), ventricular arrhythmia, decompensated heart failure, or stroke. The primary outcome was post-LT MACE at 30 days and the secondary outcome was all-cause mortality at maximal follow-up.Results:Of 461 patients undergoing LT, 350 had suitable CTs for analysis, of which 90 (25.7%) had also undergone CT coronary angiography. High AAC was identified in 98 patients (28.0%). This finding demonstrated a moderate correlation with high coronary artery calcium score (CACS) ≥400 (r=0.52, p

Circulation, Volume 150, Issue Suppl_1, Page A4139327-A4139327, November 12, 2024. Leadless pacemakers (LPMs) represent a significant advancement in cardiac pacing technology, offering several advantages over traditional transvenous systems. However, they are not without complications such as leadless pacemaker-induced cardiomyopathy (LPM-CMP). We present a case of cardiogenic shock from LPM-CMP requiring cardiac resynchronization therapy (CRT) as a rescue strategy.A 77-year-old female with a history of heart failure with reduced ejection fraction, coronary artery disease status post recent percutaneous coronary intervention to the proximal-to-mid left anterior descending artery, complete heart block status post LPM implantation, and chronic kidney disease stage 3b, presented to the emergency department after a syncopal event. Initial vital signs were blood pressure 96/64 mmHg and heart rate 62 bpm, while LPM interrogation showed 100% right ventricular pacing burden. Physical exam revealed congestion with jugular venous distension and 2+ pitting bilateral lower extremity edema. Initial labs (BNP 4792 pg/mL, hs-troponin 202 ng/L, lactate 5.5 mmol/L, AST/ALT 68/30 U/L, and creatinine 3.3 mg/dL (baseline 1.5 mg/dL)) were consistent with SCAI Stage B cardiogenic shock. She was transferred to the cardiovascular intensive care unit for inotropic and vasopressor support. By hospital day 10, she was on 10 mcg/kg/min of dobutamine, 3 mcg/min of epinephrine, and 14 mcg/min of norepinephrine. Despite this and extensive diuresis, she continued to deteriorate. After ruling out acute coronary syndrome, LPM-CMP was suspected as the etiology, and CRT-D was implanted on day 14. Echocardiography-assessed stroke volume correspondingly improved from 25 mL on pressors to 30 mL after CRT-D and off pressors. She was subsequently optimized on heart failure guideline-directed medical therapy, and discharged home on day 19.LPM-CMP is a rare but potentially serious complication of LPM implantation. Early recognition and appropriate management are essential for optimizing patient outcomes. In this case, CRT-D implantation proved to be a successful intervention, resulting in significant clinical improvement and symptom resolution. This underscores the importance of individualized patient management and the role of advanced device therapies in the treatment of LPM-induced complications. Further research is needed to better understand the risk factors, pathophysiology, and optimal management strategies for LPM-CMP, especially as a rescue strategy in cardiogenic shock.

Circulation, Volume 150, Issue Suppl_1, Page A4127931-A4127931, November 12, 2024. Introduction:Acute coronary syndrome (ACS) is associated with significant morbidity and mortality. Management of ACS includes percutaneous coronary intervention (PCI) and requires the use of antithrombotic therapy, which increases bleeding risk. Chronic steroid use (CSU) is common for many diseases and is also associated with bleeding risk and impaired wound healing. However, data on outcomes of patients with CSU and AMI are sparse.Methods:Patients admitted for ACS and managed with PCI from 2014 to 2020 with and without CSU were identified using the National Readmissions Database (NRD). In-hospital outcomes include death, arterial thrombosis (composite of ischemic stroke and arterial thromboembolism), and major bleeding (composite of gastrointestinal, intracranial, or post-procedure bleeding or transfusion). Ninety-day readmission outcomes were cardiovascular (CV)-related, bleeding-related and all-cause. Multivariable logistic or Cox proportional hazards were utilized.Results:A total of 1,087,357 patients with ACS were included, of whom, 9,864 (0.9%) had CSU. After multivariable adjustment, there was no significant difference in in-hospital mortality (3.1% vs 3.2%; OR 1.09, 95% CI 0.93-1.26) or risk of arterial thrombosis (3.3% vs 2.8%; OR 0.91, 95% CI 0.81-1.02) between patients with and without CSU. CSU was associated with an increased risk of major bleeding events (8.3% vs 6.0%; OR 1.15, 95% CI 1.06-1.25). CSU was associated with a higher risk of CV-related (10.7% vs 7.5%; HR 1.10, 95% CI 1.02-1.18), bleeding-related (2.3% vs 1.2%; HR 1.28, 95% CI 1.09-1.51), and all-cause 90-day readmissions (23.9% vs 14.9%; HR 1.28, 95% CI, 1.22-1.34).Conclusion:Among patients admitted with ACS who underwent PCI, CSU was associated with increased risk of bleeding during index hospitalization and readmissions for bleeding. Furthermore, CSU was associated with increased risk of 90-day CV and all-cause readmission. Further studies are needed to better characterize this risk.

Circulation, Volume 150, Issue Suppl_1, Page A4144104-A4144104, November 12, 2024. Introduction:Following myocardial infarction (MI), extracellular matrix (ECM) degradation significantly contributes to adverse left ventricular (LV) remodeling mediated by the activation of matrix metalloproteinases (MMPs). Intramyocardial injection of hydrogels that locally release MMP inhibitors are designed to modulate MMP activation, increase wall thickness, reducing wall stress, resulting in improved regional mechanics and function. Pressure-volume (PV) analysis is an established approach for evaluation of cardiac performance.Methods:Chronic reperfused MI was created by a 90-min LAD occlusion in swine (n=16). PV loop analysis was performed using simultaneous 3D echocardiography and invasive LV pressures at baseline and 5 weeks post-MI. Therapeutic hydrogels were delivered by direct intramyocardial injection (9×100 μl) at 7 days post-MI using hyaluronic acid hydrogels alone (HA-Only) (n=4) or hyaluronic acid that releases an MMP inhibitor doxycycline (HA-DOX) (n=5) into the MI region. Outcomes were compared to control MI pigs (n=7) at 5 weeks post-MI to assess therapeutic benefits. MMP inhibition was measured by uptake of the SPECT MMP targeted radiotracer,99mTc-RP805 in the infarct region.Results:Quantitative indices of remodeling from representative PV loops are shown in Figure 1 A-C. LV end-diastolic volume (LVEDV) corrected for body weight (BW) was significantly greater in the MI-controls at 5 weeks post-MI compared to the HA-DOX group (Fig 1D, p=0.035, t-test). There was a statistically significant difference in LV end-diastolic pressure (LVEDP) (Fig 1E) between MI-controls and HA-DOX (p=0.025, ANOVA). There was a trend for decreased LV compliance (Fig 1F) in MI-controls based on the EDPVR V30. These changes correlated with a significant decrease in99mTc-RP805 in the MI region of HA-DOX animals compared to controls (Fig 1G).Conclusion:LV PV analysis demonstrated significant adverse remodeling in control pigs that was reduced by early intramyocardial delivery of a DOX releasing hydrogel post-MI. Delivery of both hydrogels prevented some measures of adverse LV remodeling, with prevention of LV dilatation and reduction in LVEDP and correlated with a decrease in MMP activation by SPECT99mTc-RP805.

Circulation, Volume 150, Issue Suppl_1, Page A4136334-A4136334, November 12, 2024. Background:Despite the availability of effective lipid-lowering therapies (LLTs), most patients (pts) with ASCVD do not meet guideline-recommended LDL-C goals. In VICTORION-INITIATE (NCT04929249), an “inclisiran first” (IF) strategy of adding inclisiran immediately on failure to achieve LDL-C

Circulation, Volume 150, Issue Suppl_1, Page A4146351-A4146351, November 12, 2024. Failure to rescue a subject sustaining sudden cardiac arrest is a public health issue requiring urgent action. The awareness, knowledge&skills of HOCPR is very low and the need-gap is very high in India with world’s largest and diverse population (socioeconomic, cultural, linguistic&educational). We undertook a structured multicentred approach with the following elements for improving HOCPR awareness, education&training for generalisability and scalability: i) an IRB/IEC approved pre-post training survey; ii) train-the-trainer program iii) pilot study in one district of a state; iv) validation study in 5 states (data validation is available for 4 out of 5 sites as of now) located in disparate regions of India with part financial support through AHA grants in aid.The pilot cohort of 46,012 trainees covered 27 of 32 revenue divisions (mandals) in one state, comprising students and community members of diverse sections of society. Pre- post training statistical analyses include McNemer’s test&ChiSquare.Results:The reason for non-readiness for HOCPR was” do not know how” in 92.9% of trainees in pre-test, and 98.6% reported that they learnt HOCPR in post -test(p

Circulation, Volume 150, Issue Suppl_1, Page A4118338-A4118338, November 12, 2024. Background :Predictors of decreased fractional flow reserve at left circumflex coronary artery after left main (LM) crossover stenting are still lacking. The objectives of the present study were to provide the predictors for low FFR at LCx and the possible treatment strategies for the compromised LCx-together with their long term outcomes.Methods:Total of 563 included patients out of 1974 patients admitted to our hospital from February 2015 to November 2020 with significant distal LM-bifurcation lesion. The enrolled patients underwent single-stent cross-over PCI under IVUS-guidance with further LCx-intervention as indicated by measured FFR.Results:The included patients showed angiographic significant LCx ostial affection after LM-stenting, but only 116 (20.6%) patients had FFR

Circulation, Volume 150, Issue Suppl_1, Page A4144603-A4144603, November 12, 2024. Introduction:An early and accurate diagnosis of occlusion myocardial infarction (OMI) by an electrocardiogram (ECG) is critical for prompt catheterization lab activation (CLA) for primary percutaneous coronary intervention (PCI).Objective:To evaluate the predictive accuracy of a new mobile application, utilizing an artificial intelligence (AI) deep learning algorithm, for distinguishing cases of OMI from non-OMI among actual Emergency Department (ED) patients assessed for potential CLA.Methods: We conducted a retrospective analysis of adult patients assessed for potential CLA in the ED at Barnes Jewish Hospital, St. Louis, MO, from August 22, 2023 to April 6, 2024. Patients arriving post-cardiac arrest were excluded. The ECG obtained immediately prior to each CLA was re-analyzed using a mobile device application with the OMI ECG AI algorithm, known as the Queen of Hearts (QoH) model. Each ECG was then categorized as either OMI or non-OMI. Coronary angiograms were reviewed blinded to the ECG results.Results:Out of 102 CLAs, 57 patients were accepted for emergent coronary angiography. The QoH model predicted 54 patients (52.9%) as having an OMI. Patients predicted to have an OMI were more likely to be accepted for coronary angiography (94% vs. 17%), have primary PCI performed (85% vs. 2.1%), and have acute coronary thrombosis detected (74.1% vs. 0.0%) on coronary angiography compared to non-OMI patients. All 46 patients fulfilling STEMI ECG criteria were correctly identified as having an OMI. Two patients predicted to have OMI without STEMI ECG criteria were found to have acute coronary occlusion. Patients with OMI had higher peak high-sensitivity troponin values. Among the 55 patients predicted to have non-OMI, 41 of 45 (91.1%) were not accepted for emergent coronary angiography and 6 of 10 (60.0%) patients accepted for emergent coronary angiography did not have obstructive coronary artery disease.Conclusions:The AI-based QoH model was highly predictive of OMI confirmed at coronary angiography. Implementation of this model may help clinicians identify the risk of OMI in patients triggering a CLA, and utilization of the AI-model could have led to potential reduction of false-positive CLAs.

Circulation, Volume 150, Issue Suppl_1, Page A4144673-A4144673, November 12, 2024. Background:Left atrial appendage occlusion (LAAO) is an alternative primary stroke prevention strategy for patients with atrial fibrillation (AF) who cannot tolerate anticoagulation (AC). Following LAAO implantation, patients typically undergo testing after 45 days to confirm successful occlusion and potentially discontinue AC. Some patients with LAAO may require cardioversion (CVN) due to recurrent AF. However, data is limited on whether post-CVN management in these patients should mirror that of patients without LAAO. Therefore, we report the outcomes of patients with LAAO who underwent CVN and were empirically treated with or without AC post-CVN.Methods:Using the TriNetX database, we identified patients aged ≥ 18 years who had LAAO, underwent CVN, and were not on AC prior to the procedure. Patients were included if they received AC for at least 4 weeks after CVN (AC group) or did not receive AC (Non-AC group). Propensity score matching was performed to adjust for confounders between the two groups. Thromboembolic and bleeding outcomes were assessed at 1 year post-CVN.Results:Among 1,086 patients, 84 (7.7%) received anticoagulation after CVN. After propensity score matching, 158 patients (79 in each group) were included, with a mean age of 71.8 ± 11.3 years (49% female) in the AC group and 70.6 ± 12.5 years (39% female) in the Non-AC group. At 1 year, the incidence of composite thromboembolic events was similar between the AC and Non-AC groups (12.7% vs. 12.7%; OR = 1.00, 95% CI: 0.39-2.55). Most thromboembolic events occurred within 2 weeks post-CVN. There were no significant differences in the composite outcomes of intracranial bleeding, gastrointestinal bleeding, or need for blood transfusion between the AC and Non-AC groups at 1 year (OR = 0.86, 95% CI: 0.30-2.25).Conclusion:Data suggest that most patients with LAAO do not receive AC after CVN. Additionally, the use of anticoagulation post-CVN in patients with LAAO did not statistically reduce thromboembolic events nor increase bleeding risk.

Circulation, Volume 150, Issue Suppl_1, Page A4142114-A4142114, November 12, 2024. Background:Atrial fibrillation (AF) is closely associated with obesity, and epicardial adipose tissue (EAT) has been proposed as a possible promoter of fibrosis and predictor of AF recurrence post-ablation. The impact of ablation on left atrial (LA) EAT, as well as that of LAEAT on ablation-induced scarring, have not been explored. Our aim was to assess changes in LAEAT volume following ablation and the association of LAEAT with ablation-induced scarring and AF recurrence.Methods:This is a single-center observational study of AF patients undergoing their first catheter ablation at the University of Washington. Cardiac MRIs were done pre- and post-ablation. LGE-MRI and Dixon sequences were used to assess ablation-induced scarring and LAEAT (Panel A). 3D atrial models of fibrosis and ablation-induced scar with superimposed EAT were created (Panel B). Patients were followed prospectively for AF recurrence.Results:We included 14 patients, aged 68 (60-74) years, 64% male, and 71% with paroxysmal AF. Radiofrequency ablation was performed in 8 (57%) patients and cryoballoon ablation in 6 (43%) for pulmonary vein isolation. Median BMI was 27.2kg/m2 and left atrial volume (LAV) was 115.65 ml. LAEAT decreased from 35.47ml (28.6-53.9) to 19.37ml (11.48-30.65) post-ablation (p

Circulation, Volume 150, Issue Suppl_1, Page A4148154-A4148154, November 12, 2024. Background:The AngioVac mechanical aspiration system has recently emerged in the literature for its use in the percutaneous debulking of intracardiac vegetations and masses. However, description of gender-related outcomes and analysis has remained sparse. We present our unique experience with the AngioVac system in men compared to women with tricuspid valve infective endocarditis (TVIE) and high or prohibitive operative risk.Methods:We performed a retrospective, in-hospital analysis comparing all men and women who underwent percutaneous AngioVac vegetation debulking in the setting of TVIE from January 2017 to December 2023 at a large academic tertiary care hospital.Results:Of the 62 patients who underwent AngioVac debulking between January 2017 and December 2023, 32 (51.6%) were women with a mean age of 35.921 +/- 9.976 years. The mean length of the vegetation was 19.581 +/- 7.478 mm and time (days) to blood culture clearance was 8.667 +/- 7.799. Of the 62 patients, 30 (48.4%) were men with a mean age of 41.711 +/- 13.627 years. The mean length of the vegetation was 21.759 +/- 7.836 mm, and time (days) to blood culture clearance was 6.188 +/- 3.692. During their index admission, between both men and women, there was no difference in time (days) from procedure to blood culture clearance (P-value: 0.239, 95% CI: -6.717 – 1.758). There was no difference in the risk of stroke (P-value 0.489, 95% CI: 0.00 – 5.852), systemic embolism (P-value: 0.577, 95% CI: 0.124 – 164.863), vascular access bleeding (OR: 0.966, 95% CI: 0.011 – 78.416), or blood transfusion requirement (P-value 0.799, 95% CI: 0.270 – 2.622). There was no difference in risk of recurrent endocarditis (P-value: 0.712, 95% CI: 0.265 – 9.147) or worsening tricuspid regurgitation post-procedure (P-value: 0.470, 95% CI: 0.075 – 3.113). Finally, there was no difference in the length of hospital stay (days) between both groups (P-value: 0.990, 95% CI: -11.748 – 11.605), and there was no difference in in-hospital mortality post-procedure (P-value: 0.354, 95% CI: 0.384 – 218.472). Notably, neither of the two groups required surgical or percutaneous tricuspid valve replacement.Conclusion:This retrospective, comparative analysis adds to the growing literature that Angiovac debulking may be a safe and effective long-term alternative to cardiac surgery in both men and women with TVIE and elevated perioperative risk.