Role of Gallium-SPECT-CT in the Management of Patients With Ventricular Assist Device-Specific Percutaneous Driveline Infection.

Abstract

BACKGROUND:

Percutaneous driveline infection is a major complication of left ventricular assist device (LVAD). This study evaluated the role of gallium-67 single-photon emission computed tomography (Ga-SPECT)-CT in LVAD-specific percutaneous driveline infection.

METHODS:

Thirty-six patients with implantable continuous-flow LVAD, who underwent Ga-SPECT-CT to evaluate percutaneous driveline infections, were enrolled and divided into uptake and no-uptake groups based on tracer concentration uptake on Ga-SPECT-CT. Primary outcomes were surgical intervention and readmission for driveline infection.

RESULTS:

Twenty-two patients had uptake on Ga-SPECT-CT. No significant differences were noted in patient characteristics, wound appearance, or laboratory results. The prevalence of positive skin culture at the driveline exit site (DLES), and usage and duration of antibiotics did not differ. However, the uptake group had higher 1-year event rates (surgical intervention: 39% vs 0%, P = .019; readmission: 74% vs 6.9%, P = .0016). In addition to positive skin culture at DLES and short duration of antibiotic therapy, uptake on Ga-SPECT-CT was a risk factor for surgical intervention (odds ratio 9.00; P = .018) and readmission (odds ratio 7.86; P = .0051).

CONCLUSIONS:

Ga-SPECT-CT could be one of the clinical modalities for guiding the treatment of driveline infection in patients with a LVAD.

• Authors: Yuki Kimura, Osamu Seguchi, Hiroki Mochizuki, Keiichiro Iwasaki, Koichi Toda, Yuto Kumai, Kensuke Kuroda, Seiko Nakajima, Emi Tateishi, Takuya Watanabe, Yorihiko Matsumoto, Satsuki Fukushima, Keisuke Kiso, Masanobu Yanase, Tomoyuki Fujita, Junjiro Kobayashi, Norihide Fukushima
• Journal: Journal of cardiac failure (J Card Fail) Vol. 25 Issue 10 Pg. 795-802 (Oct 2019) ISSN: 1532-8414 [Electronic] United States
• PMID: 31454687 (Publication Type: Journal Article)
• Copyright: Copyright © 2019 Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Gallium Radioisotopes
• Radiopharmaceuticals
• Gallium-67

Topics

• Adult
• Anti-Bacterial Agents (administration & dosage)
• Female
• Gallium Radioisotopes (pharmacology)
• Heart Failure (surgery)
• Heart-Assist Devices (adverse effects)
• Humans
• Japan
• Male
• Patient Readmission
• Prosthesis Implantation (adverse effects, methods)
• Prosthesis-Related Infections (diagnosis, etiology, therapy)
• Radiopharmaceuticals (pharmacology)
• Retrospective Studies
• Risk Factors
• Skin (microbiology)
• Tomography, Emission-Computed, Single-Photon (methods)