Arrhythmias & electrophysiology

Mechanical Vacuum Aspiration and Debulking of Large Vegetations During Cardiac Implantable Electronic Device Extraction

J Am Coll CardiolPublished Retrospective cohort study

Authors' conclusion

In this contemporary study of PMD of large lead-associated vegetations, manual vacuum aspiration was feasible and appeared associated with better outcomes, including postoperative markers of infection severity, hospital stay, and, perhaps, mortality.

Study context

Population
Patients undergoing cardiac implantable electronic device (CIED) extraction with lead-associated vegetations, 2023–2025
Participants
42 patients
Exposure
Percutaneous mechanical debulking vs no percutaneous mechanical debulking (PMD) during CIED extraction
  • PMDn = 13
  • Controlsn = 29reference
Outcome
Change in WBC count postprocedure vs baseline
Methodological details3 centres
  • 3 centres

Main finding

As reported in the abstract

Change in WBC count postprocedure vs baseline PMD mean 8.35% · Controls mean 21.1%

>20% increase

  • PMD vs Controls: P = 0.046 — WBC decreased with PMD, increased in controls

Observational data: associations, not effects.

Further findings

Postextraction hospital stay

P = 0.056

One-month mortality

P = 0.401

Safety

Extraction in both cohorts without major complications

Original publication

Mechanical Vacuum Aspiration and Debulking of Large Vegetations During Cardiac Implantable Electronic Device Extraction. J Am Coll Cardiol. Published 7 October 2025. doi:10.1016/j.jacc.2025.07.043

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