(669) - Drive Line Infections Are Not Associated with an Increased Incidence of Thromboembolic Complications in Patients on Continuous Flow LVAD Support

Abstract

We reviewed our single institutional experience of continuous flow left ventricular assist devices (LVADs) to determine the impact of driveline (DL) infections on the incidence of thromboembolic complications. Between March 2006 and May 2015, 231 patients underwent implantation of 240 LVADs - 127 (52.9%) as bridge to transplant and 113(47.1%) as destination therapy. Effect of DL infections on stroke, pump thrombosis, and survival was assessed. There were 24 (10.0%) patients who developed a DL infection, 6 (25%) were female, and 11 (45.8%) destination therapy patients. Freedom from stroke was similar for patients with and without DL infections - 92.5% vs. 91.0% at 6 months, 77.0% vs. 87.0% at 1 year, and 70.5% vs. 81.0% at 2 years; p=0.273. The incidence of pump thrombosis was also similar - 4.2% vs. 3.7%%; p=0.999. Survival was similar between the groups with 1-month, 6-month, 1-year, and 2-year survivals of 100.0%, 100.0%, 94.7%, and 94.7%, respectively, for DL infection patients, versus 93.5%, 85.8%, 79.6%, and 69.8%, respectively, for patients without DL infections (p=0.259). DL infection was not a significant predictor of survival in Cox proportional hazard regression (HR 1.58, p=0.277). Drive line infections were not associated with a higher incidence of thromboembolic complications. Based on these data, it does not appear necessary to raise anticoagulation target goals in the setting of a DL infection.