Management of left ventricular assist device infection with heart transplantation.
BACKGROUND
Left ventricular assist devices (LVADs) are being used as bridges to heart transplantation (HT). Infection of the LVAD in this patient population represents a serious complication, as simple LVAD removal or delaying HT may result in death. To improve outcomes in this group of patients, we performed HT in the presence of LVAD infection.


METHODS
Eighteen patients underwent LVAD implantation followed by HT. Ten underwent HT in the absence of LVAD infection (group 1); and 8, in the presence of LVAD infection (group 2). All patients were treated similarly except for modification of immunosuppression in group 2 patients.


RESULTS
Infectious and noninfectious complications were equivalent between the two groups. There was no difference between groups in regard to intraoperative deaths (one versus none), long-term survival (8/10 versus 7/8), wound complications (three versus none), and mean length of hospital stay after HT (21 versus 26 days).


CONCLUSIONS
Patients with LVAD infection are too seriously ill to allow LVAD removal or delay of HT. Transplantation in the face of infection is an effective treatment option.
Prendergast
T W
TW
Section of Cardiac and Thoracic Surgery, Temple University Health Sciences Center, Philadelphia, Pennsylvania, USA.
Todd
B A
BA
Beyer
A J
AJ
Furukawa
S
S
Eisen
H J
HJ
Addonizio
V P
VP
Browne
B J
BJ
Jeevanandam
V
V
D006331:Heart Diseases / Q000150:complications / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D007165:Immunosuppression Therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016459:Prosthesis-Related Infections / Q000150:complications / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis
D007166:Immunosuppressive Agents