title: [Reconstructive surgery in patients with a ventricular assist device (VAD)--an interdisciplinary challenge].
abstract: BACKGROUND
  Ventricular assist devices (VAD) are implanted with a growing frequency in patients with end-stage heart failure. In spite of technical and therapeutic advances, there is still a high incidence of device infections and healing disturbances with a considerable mortality. Reconstructive plastic surgery is able to provide help in erradicating infections and covering defects.
  
  
  METHODS
  11 patients with device infections and soft tissue defects were treated in our institution. All cases were treated with local myocutaneous or muscle flaps.
  
  
  RESULTS
  Three patients had postoperative haematomas which had to be revised surgically. One patient had a persistent fistula of mediastinal origin but without clinical symptoms of infection. One patient exhibited an enterocutaneous fistula after defect coverage.
  
  
  CONCLUSIONS
  Patients with VADs have a high possibility of perioperative complications. Therefore a close interdisciplinary approach with plastic and cardiovascular surgeons is absolutely essential.
authors.affiliation: Krankenhaus Bethel, Klinik für Plastische, Ästhetische und Handchirurgie, Bückeburg. o.frerichs@krankenhaus-bethel.de
authors.forename: O
authors.initials: O
authors.lastname: Frerichs
authors.forename: M
authors.initials: M
authors.lastname: Morshuis
authors.forename: M
authors.initials: M
authors.lastname: Schoenbrodt
authors.forename: J
authors.initials: J
authors.lastname: Gummert
authors.forename: H
authors.initials: H
authors.lastname: Fansa
mesh_terms: D000328:Adult; D000368:Aged; D015897:Comorbidity; D003299:Cooperative Behavior; D005260:Female; D005402:Fistula / Q000601:surgery; D005500:Follow-Up Studies; D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices; D006801:Humans; D033183:Interdisciplinary Communication; D007412:Intestinal Fistula / Q000601:surgery; D008297:Male; D008477:Mediastinal Diseases / Q000601:surgery; D008875:Middle Aged; D010348:Patient Care Team; D011183:Postoperative Complications / Q000601:surgery*; D019106:Postoperative Hemorrhage / Q000601:surgery; D016459:Prosthesis-Related Infections / Q000601:surgery; D019651:Plastic Surgery Procedures; D012086:Reoperation; D013524:Surgical Flaps; D013530:Surgical Wound Infection / Q000601:surgery*