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.