{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T15:24:33Z","timestamp":1761578673018,"version":"3.37.3"},"reference-count":6,"publisher":"Georg Thieme Verlag KG","issue":"16","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dtsch Med Wochenschr"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Die Inzidenz von Rechtsherzendokarditiden nach Infektion kardialer Implantate ist in den letzten Jahren gestiegen und mit hoher Wahrscheinlichkeit auf die zunehmende Anzahl an Implantationen zur\u00fcckzuf\u00fchren. Die Katheter-gest\u00fctzte Aspirationstherapie kann eine Therapieoption in einer Hochrisikokonstellation darstellen.<\/jats:p><jats:p>Anamnese\u2002Ein 65-j\u00e4hrige Patient wurde aufgrund einer Rechtsherzendokarditis mit Beteiligung eines kardialen elektronischen Implantats \u00fcberwiesen. Vorbestehend war eine isch\u00e4mische Kardiomyopathie bei 3-Gef\u00e4\u00df-KHK mit Z.\u200an. extrakorporaler kardiopulmonaler Reanimation mit entsprechend sekund\u00e4r prophylaktischer Implantation eines Kardioverter-Defibrillators.<\/jats:p><jats:p>Untersuchung und Diagnose\u2002Echokardiografisch zeigten sich Endokarditis-typische Vegetationen an der Sonde des Kardioverter-Defibrillators sowie an der kompetenten nativen Trikuspidalklappe. In der weiterf\u00fchrenden Diagnostik ergab sich ein Nachweis einer mutma\u00dflich septischen pulmonalen Embolie.<\/jats:p><jats:p>Therapie und Verlauf\u2002Prim\u00e4r erfolgte die Explantation des Kardioverter-Defibrillators. Bei persistierender Bakteri\u00e4mie und im Verlauf protrahiertem septischem Schock erfolgte eine umfassende antiinfektive Therapie. Zur Fokussanierung erfolgte bei hohem operativem Mortalit\u00e4tsrisiko im interdisziplin\u00e4ren Konsens eine interventionelle Aspirationstherapie der Vegetation mithilfe herk\u00f6mmlicher kardiologischer Kathetertechnik unter Erhalt der Klappenfunktionalit\u00e4t<\/jats:p><jats:p>Folgerung\u2002Eine Katheter-gest\u00fctzte Aspirationstherapie bei Rechtsherzendokarditis kann in einer Hochrisikokonstellation eine Alternative zur operativen Versorgung darstellen, bleibt jedoch aufgrund der unzureichenden Studienlage eine individuelle Therapieentscheidung.<\/jats:p>","DOI":"10.1055\/a-1537-8557","type":"journal-article","created":{"date-parts":[[2021,8,20]],"date-time":"2021-08-20T22:37:34Z","timestamp":1629499054000},"page":"1060-1063","source":"Crossref","is-referenced-by-count":2,"title":["Aspirationstherapie einer Trikuspidalklappenvegetation bei Rechtsherzendokarditis nach infekti\u00f6ser Endokarditis eines kardialen Implantats in einer Hochrisikokonstellation"],"prefix":"10.1055","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-5675","authenticated-orcid":false,"given":"Lukas Andreas","family":"Heger","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Medizinische Interdisziplin\u00e4re Intensivstation, Universit\u00e4t Freiburg"},{"name":"Klinik f\u00fcr Kardiologie und Angiologie I, Universit\u00e4ts-Herzzentrum Freiburg-Bad Krozingen, Medizinische Fakult\u00e4t, Universit\u00e4t Freiburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asieb","family":"Sekandarzad","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Medizinische Interdisziplin\u00e4re Intensivstation, Universit\u00e4t Freiburg"},{"name":"Klinik f\u00fcr Kardiologie und Angiologie I, Universit\u00e4ts-Herzzentrum Freiburg-Bad Krozingen, Medizinische Fakult\u00e4t, Universit\u00e4t Freiburg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Wengenmayer","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Medizinische Interdisziplin\u00e4re Intensivstation, Universit\u00e4t Freiburg"},{"name":"Klinik f\u00fcr Kardiologie und Angiologie I, Universit\u00e4ts-Herzzentrum Freiburg-Bad Krozingen, Medizinische Fakult\u00e4t, Universit\u00e4t Freiburg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2021,8,20]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"e003016","DOI":"10.1161\/JAHA.115.003016","article-title":"Validated Risk Score for Predicting 6-Month Mortality in Infective Endocarditis","volume":"5","author":"L P Park","year":"2016","journal-title":"J Am Heart Assoc"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1055\/s-0031-1278347","article-title":"Cardiac device-related endocarditis: Epidemiology, pathogenesis, diagnosis and treatment \u2013 a review","volume":"18","author":"S Edelstein","year":"2009","journal-title":"Int J Angiol"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1016\/S0022-5223(19)35306-1","article-title":"Reparative approach for right-sided endocarditis. 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