title: A simple device to secure ventricular assist device driveline and prevent exit-site infection.
abstract: OBJECTIVE
  Driveline infections are one of the most common and important complications in patients with left ventricular assist device (LVAD). One of the causes favouring the development of this complication is the traumatism of the exit site, which occurs in response to movement of the driveline. In this work, we present a simple and feasible method to immobilize the driveline at the level of the exit site.
  
  
  METHODS
  From April 2013 until November 2013, 6 patients underwent implantation of HeartWare LVAD (HVAD) for an end-stage heart failure. When the patient has begun to mobilize after the implantation of the device, we have combined the use of two components with the aim of securing the driveline to the patient's skin: a StatLock system and a silicone suture.
  
  
  RESULTS
  No case of local traumatism and no case of local infection at the driveline were observed during the follow-up. No patient reported pain or swelling at the driveline exit site. All patients were satisfied with their quality-of-life and they do not report any limitations in their daily activities.
  
  
  CONCLUSIONS
  One of the major long-term complications in patients with LVAD is the development of infections of the exit site of the driveline. The trauma of this skin region promotes the onset and maintenance of an inflammatory process and local infectious. Avoiding excessive mobilization of the driveline is likely to reduce the incidence of infections of the exit site and improve the quality-of-life.
authors.affiliation: Division of Cardiac Surgery, San Giovanni Battista Hospital 'Molinette', University of Turin, Turin, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Baronetto
authors.forename: Paolo
authors.initials: P
authors.lastname: Centofanti
authors.forename: Matteo
authors.initials: M
authors.lastname: Attisani
authors.forename: Davide
authors.initials: D
authors.lastname: Ricci
authors.forename: Baudolino
authors.initials: B
authors.lastname: Mussa
authors.forename: Roger
authors.initials: R
authors.lastname: Devotini
authors.forename: Erika
authors.initials: E
authors.lastname: Simonato
authors.forename: Mauro
authors.initials: M
authors.lastname: Rinaldi
mesh_terms: D000328:Adult; D000368:Aged; D006333:Heart Failure / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D012042:Registries; D013536:Suture Techniques; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Driveline; Exit site; Heart failure; Infection; Ventricular assist device