Nonvalvular Cardiovascular Device–Related Infections

Baddour, Larry M.; Bettmann, Michael A.; Bolger, Ann F.; Epstein, Andrew E.; Ferrieri, Patricia; Gerber, Michael A.; Gewitz, Michael H.; Jacobs, Alice K.; Levison, Matthew E.; Newburger, Jane W.; Pallasch, Thomas J.; Wilson, Walter R.; Baltimore, Robert S.; Falace, Donald A.; Shulman, Stanford T.; Tani, Lloyd Y.; Taubert, Kathryn A.

doi:10.1161/01.cir.0000093201.57771.47

Cited by 438 publications

(353 citation statements)

References 174 publications

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“…Shear stress between the annuloplasty ring and the MR jet is severe just after surgery and then gradually decreases as endothelialization progresses in the early postoperative phase. In animal models of valve or nonvalvular device implantation, the process of endothelialization begins as early as 1 month after surgery and is completed within 3-6 months after surgery [22][23][24][25]. Therefore, in the early postoperative phase, hemolysis can be sometimes caused by mild MR, and is often ameliorated with endolthelialization without reoperation.…”

Section: Discussionmentioning

confidence: 99%

Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

Ishida¹,

Adachi²,

Shiotsu³

et al. 2014

CEN Case Rep

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Section: Discussionmentioning

confidence: 99%

Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

Ishida¹,

Adachi²,

Shiotsu³

et al. 2014

CEN Case Rep

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“…9) Late-onset vascular PVGI are usually associated with less virulent organisms such as coagulase-negative Stapylococcus, Cirynebacterium, or Propionibacterium species. 10) It is expected that bacterial identification will be performed using metagenome analysis in the future. 11) For the treatment of prosthetic vascular graft infection in the thoracic aortic area, Coselli et al 1) reported a composite of aortic graft reconstruction and omental filling procedures after re-thoracotomy and debridement in 1999, resulting in a high 1-year mortality rate of approximately 30%.…”

Section: Discussionmentioning

confidence: 99%

A Case of an Aortic Abscess around the Elephant Trunk

Fujii

Kawasaki

Katayanagi

et al. 2015

ATCS

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A 52-year-old male patient with a history of total arch replacement using the elephant trunk technique for acute aortic dissection 4 years before visited our hospital with the chief complaint of persistent fever. Chest computed tomography (CT) suggested prosthetic vascular graft infection, which was treated surgically after chemotherapy. The first surgery consisted of debridement of an abscess around the vascular graft and in the aorta around the elephant trunk, and thoracic descending aorta replacement and vacuum-assisted closure (VAC) in view of the risk of bleeding from the peripheral region of the elephant trunk. One week later, omental filling was performed as the second step. This is a very rare case of aortic abscess around the elephant trunk that could successfully be managed by graft-conserving treatment.

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“…Lastly, the pacemaker may become hematogenously infected in the case of a bacteremia due to another infection. 10 …”

Section: Introductionmentioning

confidence: 99%

“…8,9 Similarly, infection rates related to LVAD placement demonstrate a large range of between 13% and 80% among recipients. 10 This wide variability in infection risk is in part due to different types of infections that have been included under the category of CIED-related infections. Various reports broadly included patients with surgical site infections, postoperative pneumonia, central venous catheter-related sepsis, and nosocomial urinary tract infections, in addition to infection of the CIED.…”

mentioning

confidence: 99%

“…Various reports broadly included patients with surgical site infections, postoperative pneumonia, central venous catheter-related sepsis, and nosocomial urinary tract infections, in addition to infection of the CIED. 10 Various comorbidities may contribute to CIED infections. Patients of advanced age, with congestive heart failure, with a metastatic malignancy, on corticosteroid therapy, or with renal failure are more likely to develop CIED infections thereby increasing their mortality.…”

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Treatment of Infected Cardiac Implantable Electronic Devices

Fakhro

Jalalabadi

Brown

et al. 2016

Seminars in Plastic Surgery

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Since their earliest application, cardiac implantable electronic devices (CIEDs), such as pacemakers, implantable defibrillators, and left ventricular assist devices (LVADs), have proven beneficial in the prevention of fatal cardiac-related disorders. 1 The past 50 years have seen a sharp rise in cardiac implantable device use with a resultant decline in deaths from ischemic, myocardial, and cardiac rhythm causes. 2 As the indications and guidelines governing CIED use broaden, so too does their widespread employment. 3 The rate of CIED infections has mirrored their increased use with some studies suggesting that the rate of device infections has overshadowed their implantation rate. 4 Infections pose a severe burden on patients, lead to significant health care costs and lengthy hospital stays, and may also lead to mortality. 5 When compared with noninfectious cardiac device complications, pacemaker infections result in an 8.4-to 11.6-fold increase in mortality rates along with a mean hospitalization cost ranging from $31,149 to $55,003. 6 Although both pacemakers and LVADs are implantable cardiac devices, their infection profile and treatment differ significantly due to the size of the device and the need for an external power source for the LVAD. However, both demonstrate a wide range of infection rates, with the true incidence of infection remaining elusive. 7 Topkara et al report a pacemaker infection rate of between 13% and 80%; however, others estimate it to be between 2% and 4% with rates rising 124% between years 1990 to 1999 and a 57% rise from 2004 to 2006, respectively. 8,9 Similarly, infection rates related to LVAD placement demonstrate a large range of between 13% and 80% among recipients. 10 This wide variability in infection risk is in part due to different types of infections that have been included under the category of CIED-related infections. Various reports broadly included patients with surgical site infections, postoperative pneumonia, central venous catheter-related sepsis, and nosocomial urinary tract infections, in addition to infection of the CIED. 10 Various comorbidities may contribute to CIED infections. Patients of advanced age, with congestive heart failure, with a metastatic malignancy, on corticosteroid therapy, or with renal failure are more likely to develop CIED infections thereby increasing their mortality. 9 Device Infection Diagnosis PacemakersThe diagnosis of pacemaker infections is often challenging. Pocket site infections are diagnosed clinically, often presenting with inflammatory skin changes including pain, swelling, AbstractWith their rising benefits, cardiac implantable electronic devices (CIEDs) such as pacemakers and left ventricular assist devices (LVADs) have witnessed a sharp rise in use over the past 50 years. As indications for use broaden, so too does their widespread employment with its attendant rise of CIED infections. Such large numbers of infections have inspired various algorithms mandating treatment. Early diagnosis of inciting organisms is crucial to...

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Nonvalvular Cardiovascular Device–Related Infections

Cited by 438 publications

References 174 publications

Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

Reoperation after mitral valve repair in viewpoints of kidney injury as well as hemolytic anemia

A Case of an Aortic Abscess around the Elephant Trunk

Treatment of Infected Cardiac Implantable Electronic Devices

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