Management of Right-Sided Cardiac Masses With Manual Aspiration Using AlphaVac Device: A Single-Center Case Series

Right-sided cardiac masses pose therapeutic challenges, particularly in patients at high surgical risk. The AlphaVac mechanical aspiration system (AngioDynamics) provides a minimally invasive, endovascular alternative to surgery or AngioVac (AngioDynamics). We report 6 consecutive patients managed with AlphaVac, all deemed poor surgical candidates by a multidisciplinary heart team. One patient died from severe comorbidities and persistent fungemia despite aspiration. Four achieved sufficient debulking, allowing stabilization or definitive antimicrobial therapy when infected. One required transfer for valvular replacement due to aortic valve endocarditis with perforation and systemic embolism. AlphaVac enabled effective aspiration in high-risk patients unsuitable for immediate surgical intervention.