Clinical Manifestations and Management of Left Ventricular Assist Device-Associated Infections

Abstract

Clinical manifestations of LVADI vary on the basis of the type of infection and the causative pathogen. Mortality remained high despite combined medical and surgical intervention and chronic suppressive antimicrobial therapy. Based on clinical experiences, a management algorithm for LVADI is proposed to assist in the decision-making process.

Multidrug-Resistant Organism Infections in Patients with Left Ventricular Assist Devices

“…We found an overall incidence of infection of 47%, similar to that reported in previous studies. 3,7,9,14,15 Left ventricular assist device implantations are increasing in number because of increasing rates of heart failure and the shortage of donor hearts for transplanta- Data are presented as number and percentage. P <0.05 was considered statistically significant.…”

Endocarditis in left ventricular assist device

“…Heart transplantation was done in 5 of the patient due to the availability of donor's heart (20,29,31). But it's strongly emphasized that eradication of fungemia with drugs alone without LVAD removal is an impossible task (15). In summary, the effective treatment methodologies for positive outcomes in patients with LVAD endocarditis were documented to be treating a patient with systemic antibiotic suppression therapy alone, LVAD replacement, LVAD transplantation and LVAD explantation without transplantation (7).…”

Building a Bridge to Save a Failing Ventricle: Radiologic Evaluation of Short- and Long-term Cardiac Assist Devices

“…Infection.-Infection is a major and potentially devastating complication in patients with LVADs, occurring in 25%-80% of cases (42). LVADassociated infections may occur in locations ranging from the local driveline exit site and surgical pocket to the valves and blood-contacting surfaces of the LVAD (so-called endocardial LVAD-related bloodstream infections).…”

“…Infections unrelated to the presence of the LVAD, such as pneumonia or urinary tract infections, are also fairly common. Driveline site infection is the most common LVAD-associated infection (42), with staphylococci and Gramnegative bacilli being the most commonly identified pathogens (42). Continuous-flow pump designs have helped decrease the risk of infectious complications, but the presence of the device still constitutes an important hazard (43).…”