Original articleAdult cardiacRisk Analysis of Bloodstream Infection During Long-Term Left Ventricular Assist Device Support
Section snippets
Patients and Methods
The Institutional Ethics Committee of our institution approved this study, and written informed consent for the procedure was obtained from all patients before they underwent operations.
BSI in Patients With Long-Term LVAD Support
The mean duration of LVAD support was 584 ± 389 days (range, 17 to 1,703 days; median, 527 days). We identified 221 BSI events in 65 patients during LVAD support (Table 2), for a rate of 60% and incidence of 2.1 ± 6.5 BSI events per patient per 365 LVAD days. Among them, BSI was related to inflow or outflow cannula infections in 52, device endocarditis in 2, and indwelling central catheter infections in 11. BSI caused by a pacemaker infection developed in 1 patient who received steroid
Comment
Infection is a significant cause of morbidity and death in LVAD patients. Sepsis accounted for 41% of deaths in patients with a pulsatile HeartMate LVAD [12], and even in patients with the newer-generation HeartMate II LVAD, sepsis accounted for 20% of deaths at 6 months after implantation [13]. Because BSI is regarded as an important sign of sepsis [14], LVAD patients with active BSI are upgraded to United Network for Organ Sharing (UNOS) priority 1A for urgent heart transplantation [15, 16].
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2023, Arthroplasty TodayFDG PET/CT for Early Detection and Localization of Left Ventricular Assist Device Infection: Impact on Patient Management and Outcome
2019, JACC: Cardiovascular ImagingCitation Excerpt :The pathogens from driveline culture in the current study were comparable with prior reports in driveline infections. Qualified LVAD-infected patients can successfully receive heart transplantation with survival outcomes that parallel to those of other transplant recipients (17). Among an estimated 200,000 symptomatic end-stage heart failure patients on maximally tolerated medications who are candidates for heart transplantation, approximately 2,200 patients receive heart transplantation per year (18).
Ventricular Assist Device–Associated Infection
2018, Infectious Disease Clinics of North AmericaVentricular Assist Device Infections
2018, Cardiology ClinicsCitation Excerpt :VAD infection is a potential criterion to increase the listing urgency for patients on the heart transplant waitlist. Outcomes of patients with VAD infection following heart transplant are comparable with those without pretransplant VAD infection in most studies, though a few have noted inferior outcomes.16,43–47 VAD support is critical in the care of end-stage heart failure and as a bridge to heart transplantation.
Staphylococcus aureus bloodstream infection in patients with ventricular assist devices–Management and outcome in a prospective bicenter cohort
2018, Journal of InfectionCitation Excerpt :The majority of studies, however, found that even in severe VAD infections like BSI or endocarditis transplantation remains an option.6,9,10,13-15 S. aureus is the most common pathogen for foreign body infections and is responsible for many VAD-associated BSI12-14,16,17 and Table S1. S. aureus bloodstream infection (SAB) per se is a serious condition associated with a significant 30-day mortality ranging from 20% to 30%.18,19
Factors Related to the Severity of Early Postoperative Infection After Heart Transplantation in Patients Surviving Prolonged Mechanical Support Periods: Experience at a Single University
2018, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :In the present study, 37.7% of recipients had active VAD-specific infections, which is comparable with previous reports (22%-51.9%).18,28–30 Because the risk of VAD-specific infections may increase with time, the mechanical support period itself has been suggested as a potential marker of worse survival and has been the focus of recent investigations.2,11,29,31,32 Currently, the duration of the support period does not seem to affect early survival after transplantation.4,33