Predisposition to Infection and Bleeding in Mechanical Assist Devices (LVADs) Recepients after Dental Procedures: A Single Center Experience

Abstract

<h3>Purpose</h3> Currently more than 7,000 patients with heart failure are supported with LVADs. Few patients with LVADs undergo dental procedures and are at risk of bleeding due to their anticoagulation/antiplatelet medication profile and acquired VWF deficiency. Many centers follow the AHA guidelines for the prophylaxis of bacterial endocarditis in patients with prosthetic devices. Though these guidelines are comprehensive, they do not specifically address prophylactic recommendations for patients with LVADs. We would assume that these guidelines hold true for LVADs; however there is no current evidence. <h3>Methods and Materials</h3> To assess the risk of infections and bleeding complications during dental procedures in patients with LVADs, we designed a protocol based pilot study of LVAD patients using the AHA guidelines. We followed 19 patients respective clinical course for administration of preprocedural antibiotics, continuation of their anticoagulation/antiplatelet medication, episodes of infective endocarditis, bacteremia, dental abscess, and bleeding episodes till six months after the procedure. <h3>Results</h3> [figure 1] <h3>Conclusions</h3> There was no increased risk of infections (dental abscess, pneumonia, infective endocarditis, and bacteremia) and no bleeding complications when the designed protocol was followed.