Continuous-flow devices and percutaneous site infections: Clinical outcomes

Goldstein, Daniel J.; Naftel, David C.; Holman, William L.; Bellumkonda, Lavanya; Pamboukian, Salpy V.; Pagani, Francis D.; Kirklin, James K.

doi:10.1016/j.healun.2012.05.004

Cited by 201 publications

(120 citation statements)

References 28 publications

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“…They reported that pneumonia and sepsis are the most common infectious complications in patients supported with CF-LVADs (23% and 20%, respectively), followed by percutaneous site infections (PSIs), which occur in approximately 19% of CF-LVAD recipients by 1 year after implant and are associated with an increased risk of mortality. 5 Young age is the only predictor of PSI; while the reason for this is unknown, it is hypothesized that young patients are more active and likely to have trauma at the driveline exit site. In addition, the greater the amount of time supported by a CF-LVAD, the greater the risk of developing a PSI.…”

Section: Complications Of Infectionmentioning

confidence: 99%

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

Trachtenberg¹,

Cordero‐Reyes²,

Elias³

et al. 2015

Methodist DeBakey Cardiovascular Journal

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Section: Complications Of Infectionmentioning

confidence: 99%

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

Trachtenberg¹,

Cordero‐Reyes²,

Elias³

et al. 2015

Methodist DeBakey Cardiovascular Journal

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“…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.…”

Section: Discussionmentioning

confidence: 99%

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

Donahey¹,

Polly²,

Vega³

et al. 2015

Texas Heart Institute Journal

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H eart failure is a chronic disease state with substantial morbidity and mortality rates.1 End-stage heart failure is characterized by worsening symptoms despite optimal medical management, and heart transplantation is the definitive treatment. However, rates of heart failure are increasing, whereas the number of organs available for transplantation is static.2 Therefore, mechanical support for the failing heart, especially ventricular assist devices (VADs), has attracted strong interest. Left VAD (LVAD) implantation imparts higher survival rates in end-stage heart failure than does optimal medical management.3-6 Although LVADs are potentially life-saving, implantation sequelae include right ventricular failure, thromboembolism, bleeding, and infection. Investigators have reported infection rates of 18% to 59% in patients with LVADs, and mortality rates estimated at 70% for infections such as VAD-related mediastinitis and endocarditis.3,7-9 Depending on the site of the infection, treatment can range from simple wound care to device explantation.7,10 Multidrug-resistant organisms (MDROs) are increasingly prevalent and are associated with substantial morbidity and mortality rates. 11-13Patients with LVADs are at greater risk for MDRO infection because of their exposure during medical procedures and their generally longer lifespans after implantation. To our knowledge, no data have been published about the incidence of MDRO infections in patients who have LVADs. Our primary objective in this study was to determine that incidence, and our secondary objective was to evaluate outcomes and risk factors in MDRO infection. Patients and MethodsOur retrospective cohort study included patients whose permanent LVADs had been implanted at

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“…It has been reported that VAD-related infections occur in 9.8%-51.9% of patients at an average of 68 days to 9.2 months after implantation and can have a major influence on survival. [5][6][7][8][9] Although the incidence of infection decreased following the introduction of continuous flow VADs compared with pulsatile flow VADs, 8) infectious complications are increasing again due to long-term VAD use for destination therapy and other purposes. 9) However, a widely accepted regimen for preventing percutaneous site infection after VAD implantation has not been established, with different methods of disinfection being employed at various centers.…”

Section: Introductionmentioning

confidence: 99%

New Treatment for Percutaneous Sites in Patients with a Ventricular Assist Device: Nihon University Crystal Violet Method

Sezai

Niino

Osaka

et al. 2016

ATCS

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Background: Infection of the percutaneous site of a ventricular assist device (VAD) is a challenging complication. We report our experience with crystal violet Solbase (Nihon University crystal violet method) for prevention of driveline or cannula infections in VAD patients. Patients and Methods: The crystal violet method was used in 10 patients (prophylaxis in nine and treatment in one). Eight patients had an extracorporeal VAD (Nipro) and two had an implantable VAD (Heart Mate II). Results: The infection-free period was 4-623 days (mean: 144.2 ± 222.9 days). All eight patients with an extracorporeal VAD died, while the two patients with an implantable VAD (Heart Mate II) survived. Infection was improved in a patient with MRSA, and the results of bacteriological examination were always negative in the patients receiving prophylaxis. The two patients with an implantable VAD had no infection for 2 and 20 months after implantation. Conclusion: These findings suggest that the Nihon University crystal violet method is effective for prevention and treatment of driveline or cannula infections in patients with a VAD.

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Continuous-flow devices and percutaneous site infections: Clinical outcomes

Cited by 201 publications

References 28 publications

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

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

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

New Treatment for Percutaneous Sites in Patients with a Ventricular Assist Device: Nihon University Crystal Violet Method

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