Infectious Complications in Patients With Left Ventricular Assist Device: Etiology and Outcomes in the Continuous-Flow Era

Topkara, V.K.; Kondareddy, Sreekanth; Malik, Fardina; Wang, I.-Wen; Mann, Douglas L.; Ewald, Gregory A.; Moazami, Nader

doi:10.1016/j.athoracsur.2010.04.093

Cited by 266 publications

(200 citation statements)

References 22 publications

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“…CF-LVAD infection has implications in morbidity, mortality and hospital length of stay [1,3]. Slaughter et al showed that CF-LVAD infection incidence was 0.48 event per patient year which is less than the incidence of infection in pulsatile left ventricular assisted device (LVAD) (0.9 per patient year) [4].…”

Section: Discussionmentioning

confidence: 98%

The Efficacy of Acticoat-Silver Dressing in Preventing Left-entricular-Assisted Device Infections

Zainah¹,

Karthikeyan²,

Buitron³

et al. 2016

Immunochem Immunopathol

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Background: The optimal local care of continuous-flow left ventricular-assisted device (CF-LVAD) exit site in unclear. We compared silver-coated wound dressing (Acticoat) with the conventional wound care method. Methods:A retrospective case-control study was conducted at Henry Ford Hospital, a tertiary teaching hospital in urban Detroit, between 11/1/2010 and 12/31/2011. Patients were divided into 2 groups based on Acticoatdressing use. Primary outcome was first CF-LVAD infection rate.Results: Forty-two patients were included in the study. Twenty patients used Acticoat-dressing, while 22 used the control dressing. Mean age was 60.3 ± 8.9 in the intervention group and 48.6 ± 4.8 in the control group (P: 0.004). Male patients were 15 (75%) in the intervention group and 15 (68.2%) in the control group (P: 0.74). Acticoat-dressing was used for a mean duration of 64.1 ± 122.9 days. The rate of first CF-LVAD infection was 15% (3) in the Acticoat group and 31.8% (7) in the control group (P: 0.25). Mortality at 200 days was 15% (3) in the intervention group; and 4.5% (1) in the control group (P: 0.25). Ten patients were infected in the whole study (23.8%); 9 of the infected patients (90%) required hospitalization after the first infection; while 3 patients (30%) required intensive-care unit admission. Mean time to the first infection was 276.3 ± 235.8 days in the intervention group and 276.3 ± 131.5 days in the control group (P: 0.99).

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Section: Discussionmentioning

confidence: 98%

The Efficacy of Acticoat-Silver Dressing in Preventing Left-entricular-Assisted Device Infections

Zainah¹,

Karthikeyan²,

Buitron³

et al. 2016

Immunochem Immunopathol

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“…3,4) In our patient, infection of either the driveline or the VP shut tube could affect each other, and may lead to a devastating central nervous system infection or mediastinitis. An appropriate alignment of the driveline will contribute to reduce the chance of driveline and device infection or the driveline related device malfunction.…”

Section: Discussionmentioning

confidence: 99%

Thoratec HeartMate II^|^#174; Left Ventricular Assist Device Implantation in Patient with Patent Ventriculoperitoneal Shunt

Yamane

Bogar

Tabata

et al. 2012

ATCS

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We report a case of HeartMate II ® left ventricular assist device (LVAD) implantation as a destination therapy in a patient with a patent ventriculoperitoneal (VP) shunt after being suffered from subarachnoid hemorrhage. Because the patient's VP shunt was running through her right anterior chest and abdominal wall, a driveline exit site was selected in her left upper quadrant to avoid unnecessary perioperative complication in relation to the patent VP shunt tube. Tailored driveline placement was a key element of this LVAD implantation in this already sick patient with multiple comorbidities.

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“…Although there is some variation among incidence and prevalence of infection depending on the type of infection and the type of mechanical circulatory support being employed it is clear that infection is a major cause of morbidity and mortality in patients supported by MCS. In a recent series reviewing 81 patients receiving continuous-flow LVADs, patients who had an infection on VAD had a significantly prolonged hospital stay with a trend toward increased mortality in comparison with patients who did not have infection (Topkara et al, 2010). Sepsis has also been shown to significantly decrease survival in VAD patients with both continuous and pulsatile-flow devices (Topkara et al, 2010;Holman et al, 2004).…”

Section: Epidemiology Of Vad-specific Infectionmentioning

confidence: 99%

“…In a recent series reviewing 81 patients receiving continuous-flow LVADs, patients who had an infection on VAD had a significantly prolonged hospital stay with a trend toward increased mortality in comparison with patients who did not have infection (Topkara et al, 2010). Sepsis has also been shown to significantly decrease survival in VAD patients with both continuous and pulsatile-flow devices (Topkara et al, 2010;Holman et al, 2004). Prevention, diagnosis and treatment of these infections is therefore paramount in proper VAD management.…”

Section: Epidemiology Of Vad-specific Infectionmentioning

confidence: 99%

Ventricular Assist Device-Specific Infections

Pauwaa¹,

Bhat²

2011

Ventricular Assist Devices

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Infectious Complications in Patients With Left Ventricular Assist Device: Etiology and Outcomes in the Continuous-Flow Era

Cited by 266 publications

References 22 publications

The Efficacy of Acticoat-Silver Dressing in Preventing Left-entricular-Assisted Device Infections

The Efficacy of Acticoat-Silver Dressing in Preventing Left-entricular-Assisted Device Infections

Thoratec HeartMate II^|^#174; Left Ventricular Assist Device Implantation in Patient with Patent Ventriculoperitoneal Shunt

Ventricular Assist Device-Specific Infections

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