Ventricular assist device-related infections.
Heart failure is a leading cause of death in developed nations despite medical management. Cardiac transplantation is a potentially lifesaving intervention for approximately 4000 advanced heart failure patients per year; however, the demand for donor hearts far exceeds the supply. Ventricular assist devices provide temporary support for patients with severe heart failure until myocardial recovery occurs or a donor heart becomes available. For those ineligible for transplantation, ventricular assist devices may be used permanently and have demonstrated reduced mortality and an improved quality of life compared with continued medical therapy. Nonetheless, these devices are under-used, in part due to the frequency of complications. Device-related infections are one of the most frequent sequelae of ventricular assist device placement and occur in 18-59% of cases. Infections can involve any part of the device and confer substantial morbidity and mortality. Here, we provide an introduction to ventricular assist devices, explore the nature and pathogenesis of ventricular assist device-related infections, discuss problems with diagnosis, and present treatment and prevention strategies.
Gordon
Rachel J
RJ
Division of Infectious Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. rj216@columbia.edu
Quagliarello
Bianca
B
Lowy
Franklin D
FD
D002303:Cardiac Output, Low / Q000628:therapy*; D003428:Cross Infection / Q000209:etiology* / Q000517:prevention & control; D004697:Endocarditis, Bacterial / Q000209:etiology* / Q000517:prevention & control; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control; D011183:Postoperative Complications