Left ventricular assist pump pocket infection: conservative treatment strategy for destination therapy candidates.

Details

Serval ID
serval:BIB_9B1208452D8C
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Left ventricular assist pump pocket infection: conservative treatment strategy for destination therapy candidates.
Journal
The International journal of artificial organs
Author(s)
Haddad E., Lescure F.X., Ghodhbane W., Lepage L., D'humieres C., Vindrios W., Yazdanpanah Y., Nataf P., Kirsch M.
ISSN
1724-6040 (Electronic)
ISSN-L
0391-3988
Publication state
In Press
Peer-reviewed
Oui
Pages
0
Language
english
Notes
Publication types: Journal Article
Publication Status: aheadofprint
Abstract
Heart failure is a major cause of mortality and morbidity, particularly among patients with advanced disease and no access to cardiac transplantation. LVAD implantation is not only a bridge-to-transplantation option for patients awaiting a heart donor, but is often used as bridge-to-destination therapy in patients unsuited for transplantation for various reasons. LVAD infection is considered the second-most common cause of death in patients who survive the initial 6 months on LVAD support. Few reports describe the indications for chronic suppressing antibiotic therapy, device exchange, methods for exchanging infected devices, post-exchange antimicrobial management status, and the outcomes of such patients.
This is the case of a 74-year-old male patient with numerous comorbidities who received urgent surgical management for severe heart failure with a HeartMate II. Six months later he developed an LVAD pump infection with methicillin-resistant Staphylococcus epidermidis, which was diagnosed with leucocyte scintigraphy. The patient received an omental graft over the LVAD and a chronic suppressive antibiotic regime. A marked leukocyte scintigraphy showed the infection's regression 6 months after the initiation of antibiotic treatment.
We concisely reviewed the driveline infections and the main aspects of the LVAD pump infection. We reviewed options for conservative and nonconservative management and showed that conservative management of the LVAD pump infection is possible.
There are no defined recommendations for the management of LVAD pump infection. This case is among the few in the literature showing that conservative treatment of an LVAD pump infection is possible.
Pubmed
Web of science
Create date
29/04/2017 16:08
Last modification date
23/10/2019 5:13
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