Percutaneous Mechanical Aspiration in Patients With Right-Sided Infective Endocarditis

Updated: May 07, 2026

Figure 1. Percutaneous mechanical aspiration in right-sided infective endocarditis. Upper panel: The procedure involves carful imaging-guided alignment of the aspiration catheter with the target vegetation, followed by initiation of aspiration flow to achieve maximal debulking. Bottom panel: Structured approach to percutaneous mechanical aspiration in right-sided endocarditis; the DEBULK framework
  • Percutaneous mechanical aspiration (PMA) is an emerging catheter-based modality for managing right-sided infective endocarditis (RSIE), particularly in patients with inadequate response to antimicrobial therapy or those at high surgical risk.
  • This science advisory outlines the rationale and evolving role of PMA in RSIE, summarizes available evidence and procedural best practices, offers expert guidance on patient selection, device use, and safety, and highlights remaining knowledge gaps and research priorities.
  • The optimal role of PMA in RSIE remains to be defined. Current data highlight growing interest in the technique but underscore the urgent need for prospective, standardized studies to clarify its safety, efficacy, and place in clinical practice.

American Heart Association Science Advisory on Percutaneous Mechanical Aspiration for Right-Sided Infective Endocarditis

Writing Group Chair Larry M. Baddour, MD and Vice Chair Abdallah El Sabbagh, MD discuss the rationale, evidence base, and clinical considerations behind the American Heart Association science advisory on percutaneous mechanical aspiration (PMA) in right-sided infective endocarditis. The conversation highlights patient selection, procedural goals, device considerations, multidisciplinary decision-making, and key knowledge gaps guiding future research.