A Review of Infections in Patients with Left Ventricular Assist Devices:
                        Prevention, Diagnosis and Management

Trachtenberg, Barry; Cordero‐Reyes, Andrea M.; Elias, Barbara; Loebe, Matthias

doi:10.14797/mdcj-11-1-28

Cited by 55 publications

(64 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surgical techniques such as increasing intrafascial tunnelling and externalisation of the silicone portion of the driveline may help reduce infections. 2 Besides culture tests, additional imaging, such as ultrasonography or computed tomography may be warranted if underlying abscess is suspected. 3 The recommended treatment includes antimicrobial therapy, local debridement of the exit sites; surgical drainage, driveline repositioning and instalment of a wound VAC (or vacuumassisted closure) system in patients with deep infection, 4 surgical debridement and device exchange in the setting of persistent or relapsing blood stream infection (BSI) despite adequate antimicrobial and surgical therapy; pump exchange should be performed if feasible, in patients with persistent sepsis and instability due to device infection while heart transplant should be considered in haemodynamically stable transplant candidates with BSI.…”

Section: 1136/heartasia-2019-apahff24mentioning

confidence: 99%

23 Stroke outcomes in patients with left ventricular assist device

Wong

Cally

et al. 2019

Keynote Lecture

View full text Add to dashboard Cite

Left ventricular assist device (LVAD) has been used for end-stage heart failure both as bridge to transplantation (BTT) and destination therapy (DT) for patients not suitable for heart transplantation. Stroke is a major cause of morbidity and mortality associated with LVAD therapy. We aimed to review the incidence and outcome of stroke during LVAD therapy in Hong Kong.Patients who had LVAD implantation from August 2010 to August 2018 for end-stage heart failure were reviewed. A total of 65 patients had LVAD implanted for end-stage heart failure (57 as BTT, 87.7%). The majority were male (n=55, 84.6%), with mean age of 49 years. Overall survival rates were 86.2% at 6 months and 79.2% at 12 months. There were 43 HeartMate IITM, 14 HeartWareTM HVADTM and 8 HeartMate 3TM implants. Twenty neurological events occurred in 18 patients with 10 cases of disabling stroke throughout the whole study period. There were 11 haemorrhagic strokes, 7 ischaemic strokes and 2 transient ischaemic attacks. Stroke and disabling stroke rates at 6 months were 20.7% and 12.1%, respectively. Disabling strokes were more common when haemorrhagic in origin (7 out of 10) and were the commonest cause of mortality in 9 out of 15 (60%) patients throughout the study period.In conclusion, stroke remains an important cause of morbidity and mortality among Hong Kong patients receiving LVAD therapy.

show abstract

Section: 1136/heartasia-2019-apahff24mentioning

confidence: 99%

23 Stroke outcomes in patients with left ventricular assist device

Wong

Cally

et al. 2019

Keynote Lecture

View full text Add to dashboard Cite

show abstract

“…Staphylococci, Enterobacteriaceae, Pseudomonas aeruginosa, Enterococci, Candida spp.) are indicative of at least some of the possible device related organisms causing infection [20,31,34,37,40,43,44].…”

Section: Bacteremia and Sepsismentioning

confidence: 99%

Left Ventricular Assist Device Infections

Skalweit¹

2018

Advanced Concepts in Endocarditis

View full text Add to dashboard Cite

Left ventricular assist device (LVAD) infections are important causes of morbidity and mortality in patients who receive these mechanical circulatory supports as a bridge to transplantation (BTT) or as destination therapy (DT) (for individuals who are not candidates for cardiac transplant). Infections are more common among persons who received pulsatile flow LVADs as opposed to newer continuous flow (CF) devices. Other risk factors for infection include obesity, renal failure, depression and immunosuppression. An LVAD infection increases the risk of infections in persons who undergo cardiac transplantation. Infections include percutaneous site, driveline, pump pocket and pump/cannula infections; sepsis, bacteremia, mediastinitis and endocarditis. Diagnosis is achieved by monitoring LVAD flow parameters and observing typical clinical and laboratory manifestations of infection. Imaging such as PET-CT or SPECT-CT imaging can be helpful to establish a diagnosis of pump pocket infection. Echocardiography may aid in detecting native valve endocarditis and thrombus associated with the LVAD. The most common pathogens include Staphylococcus, Corynebacterium, Enterococcus, Pseudomonas and Candida spp. Treatment requires targeted antimicrobials plus surgical debridement of infected tissue and device components. In cases of pump/cannula/LVAD endocarditis, especially if fungal pathogens or Mycobacterium chimaera are involved, LVAD removal/reimplantation vs. transplant is necessary, combined with extended antimicrobial therapy.

show abstract

“…According to (1), the product k √ Q1Q2 is a Figure-Of-Merit (F OM ) for the energy transmission efficiency. Hence, using coils with high quality factors, i.e.…”

Section: A Ipt System Designmentioning

confidence: 99%

“…Using the calculation of the first harmonic of the capacitor current i C2, (1) , the first harmonic of the rectifier input voltage u 2,(1) can be obtained with…”

Section: B Load Modelingmentioning

confidence: 99%

“…The limited availability of donor organs promoted the development of Mechanical Circulatory Support Systems (MCSS) such as Left Ventricular Assist Devices (LVAD), which help the weakened heart to provide the pump capacity needed to maintain the regular blood circulation in the body. However, the percutaneous driveline that is used today to power the LVAD constitutes a severe risk of infection to the patient [1]. Therefore, Inductive Power Transfer (IPT) technology was deployed as a promising solution for powering the LVAD without the need for a galvanic contact [2].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparative evaluation of IPT resonant circuit topologies for wireless power supplies of implantable mechanical circulatory support systems

Knecht

Kolar

2017

2017 IEEE Applied Power Electronics Conference and Exposition (APEC)

View full text Add to dashboard Cite

Abstract-Today's implantable blood pumps, such as Left Ventricular Assist Devices (LVAD) are powered by means of a percutaneous driveline, which constitutes a severe risk of infection to the patient. Inductive Power Transfer (IPT) technology offers a solution to replace the driveline by a wireless energy link. In this paper, three commonly used IPT resonant circuit topologies are compared regarding power transfer efficiency and heating of the tissue. In the course of the analysis, the main advantages and disadvantages of each topology are identified and as a result it was found that regarding the heating of the tissue, the series-series compensated topology is the most promising solution for Transcutaneous Energy Transfer (TET) systems capable to provide a peak power transmission of up to 30 W. Operated at the resonant frequency using an efficiency optimal control, the series-series compensation topology achieves the highest DC-to-DC power conversion efficiency in the coil coupling and output power range, but requires a higher complexity of the control system, and more important, it shows an increasing secondary side coil power loss with decreasing coil coupling factor. In contrast, the operation near the frequency for load independent voltage gain using a load impedance control technique achieves similar power conversion efficiencies at high coil coupling factors, but offers a lower complexity of the overall TET system. The peak DCto-DC efficiency measured with a hardware prototype is 97 % at a coil separation distance of 10 mm, a primary and secondary coil diameter of 70 mm and ideal coil alignment. Even at a coil separation distance of 20 mm and an output power of 5 W, the efficiency is 90.5 %.

show abstract

A Review of Infections in Patients with Left Ventricular Assist Devices: Prevention, Diagnosis and Management

Cited by 55 publications

References 28 publications

23 Stroke outcomes in patients with left ventricular assist device

23 Stroke outcomes in patients with left ventricular assist device

Left Ventricular Assist Device Infections

Comparative evaluation of IPT resonant circuit topologies for wireless power supplies of implantable mechanical circulatory support systems

Contact Info

Product

Resources

About