title: Surgical management of Novacor drive-line exit site infections.
abstract: 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.
authors.affiliation: Division of Cardiothoracic Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA. pasquem@msnotes.wustl.edu
authors.forename: Michael K
authors.initials: MK
authors.lastname: Pasque
authors.forename: Tina
authors.initials: T
authors.lastname: Hanselman
authors.forename: Kim
authors.initials: K
authors.lastname: Shelton
authors.forename: Beth A
authors.initials: BA
authors.lastname: Kehoe-Huck
authors.forename: Robyn
authors.initials: R
authors.lastname: Hedges
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Cassivi
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Ewald
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Rogers
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D016459:Prosthesis-Related Infections / Q000601:surgery*
chemical_list: D000900:Anti-Bacterial Agents