Abstract
<h3>Purpose</h3> Driveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited data are available to describe preventive practices and their potential effectiveness. <h3>Methods</h3> We surveyed LVAD centers within the United States to assess local practices for driveline stabilization and preventive approaches towards DLIs. An online, anonymous, question-based survey was created and sent to expert providers at implanting centers. Respondents were participants in FLIGHT and IDEAL heart failure (HF) working groups and only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported rates of DLI. <h3>Results</h3> Representatives from 55 centers responded to the survey. Respondents comprised of 37 HF cardiologists, 14 cardiothoracic surgeons, 2 LVAD advanced practitioners and 2 LVAD RNs. The response rate was 95%. Centers were geographically well distributed throughout the United States and 80% reported implanting over 20 LVADs per year. Forty-five (81%) centers reported usage of an anchor stitch, 48 (87%) used an external device to stabilize the driveline, while 7 (13%) utilized a wound vacuum after device placement. Eighteen centers (33%) reported a low DLI rate in comparison to 37 (66%) reporting a high rate. Centers with low DLI rates trended to utilize an anchor stitch (94% vs. 76%, p=0.09) and wound vacuum (22% vs. 8%, p=0.14) more often than those with high DLI rates (figure 1). <h3>Conclusion</h3> Variation exists in preventive practices and DLI rates across centers. Although no significant differences were noted for assessed practices between centers with high and low DLI rates, further studies are warranted to determine the effectiveness of an anchor stitch and wound vacuum placement for preventing DLIs.
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