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Clinical Outcomes of Left Ventricular Assist Device Pump Infection.

Abstract
Few studies have focused on the clinical outcomes and risk factors of left ventricular assist device (LVAD) pump infection, and no standard treatment for LVAD pump infection has been established. Therefore, we used a therapeutic flowchart to manage LVAD pump infections. We retrospectively evaluated 220 patients who underwent continuous-flow LVAD implantation between January 2005 and March 2021 at Osaka University, Japan. First, we performed wound debridement, negative-pressure wound therapy, antibiotic treatment, and omental flap transposition. Subsequently, we administered conservative treatment, scheduled implantable LVAD exchange, or emergent removal of the implantable LVAD and exchange for extracorporeal LVAD or percutaneous LVAD (IMPELLA). Pump infections occurred in 32 patients. The survival rates of patients with pump infections during LVAD support were 93%, 74%, and 61% at 180 days, 1 year, and 2 years after LVAD pump infection, respectively. Fifteen patients underwent successful heart transplantation. Bridge-to-bridge surgery, preoperative use of venoarterial extracorporeal membrane oxygenation or percutaneous LVAD, high lactate dehydrogenase levels, and driveline infection were significantly associated with pump infection. Our study reveals that poor preoperative condition and driveline infection were significant risk factors for LVAD pump infection.
AuthorsShusuke Imaoka, Takaaki Samura, Daisuke Yoshioka, Masashi Kawamura, Takuji Kawamura, Koichi Toda, Shigeru Miyagawa
JournalASAIO journal (American Society for Artificial Internal Organs : 1992) (ASAIO J) Vol. 69 Issue 12 Pg. 1056-1064 (Dec 01 2023) ISSN: 1538-943X [Electronic] United States
PMID37549664 (Publication Type: Journal Article)
CopyrightCopyright © ASAIO 2023.
Topics
  • Humans
  • Heart Failure (surgery)
  • Retrospective Studies
  • Heart-Assist Devices (adverse effects)
  • Heart Transplantation
  • Extracorporeal Membrane Oxygenation
  • Treatment Outcome

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