Surgical management of Novacor drive-line exit site infections.
Implantable left ventricular assist device (LVAD) drive-line exit site infection, an expected consequence of currently available device use, continues to be a significant limiting factor in long-term support. We theorize that the mechanism behind the establishment of the most chronic exit site infections involves a shearing torsion injury that disrupts the tissue adherence interface with the drive-line. The resulting neo-epithelialized drainage tract prevents permanent clearance of the infection with antibiotics alone. The proposed treatment strategy of established infections involves aggressive surgical excision of the involved exit site.
Pasque
Michael K
MK
Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. pasquem@msnotes.wustl.edu
Hanselman
Tina
T
Shelton
Kim
K
Kehoe-Huck
Beth A
BA
Hedges
Robyn
R
Cassivi
Stephen D
SD
Ewald
Gregory A
GA
Rogers
Joseph G
JG
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000601:surgery*
D000900:Anti-Bacterial Agents