Abstract
Continuous-flow left ventricular assist devices (cf- LVAD) driveline infection remains a significant limiting factor regarding patients' quality of life and overall long term outcome. This retrospective study investigates the single center strategy and outcome of cf-LVAD patients with driveline infection treated both medically or surgically. All patients treated for driveline infection on cf-LVADs from December 2014 to January 2019 in our center were analyzed. Baseline data was collected. Specific data included: time from cf-LVAD implantation to driveline infection, pathogen type, treatment strategy, time from diagnosis to surgical reposition. Usually, antibiotics were used as first line therapy. The surgical approach was chosen in resistant infections. Further topic of investigation was the freedom of reinfection in the follow up time. During the study period a total of 45 patients were treated with cf-LVAD implantation. 12 (26,6%) of the patients developed a driveline infection. Additionally, two patients with implanted cf-LVAD from outside center were admitted, increasing the total number of patients to n=14. The mean time from implantation till infection diagnosis was 16.53±14.27 months (range from 3.17 to 46.63). The majority (10 patients, 71.43%) ware treated with surgical reposition [Fig.1.] and 4 patients (28.57%) were treated only medically. In the reposition group, the time from diagnosis to treatment was 122.9±176.16 days (range from 5 to 554). Three patients were additionally treated with vacuum dressing. During the follow up time (14.16±16.22 months, range from 1.27 to 54.8) two patients treated surgically developed reinfection. Surgical reposition of cf-LVAD driveline is save and probably the only effective treatment for advanced infection. Skillful use of both antibiotic and surgical approach leads to excellent long term results in this patients cohort.
Published Version
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