title: A successful management of infection of the left ventricular assist device by pump exchange: conversion from DuraHeart to Jarvik 2000.
abstract: We successfully controlled infection of a left ventricular assist device by performing pump exchange. A 53-year-old man was implanted with DuraHeart for ischemic cardiomyopathy as a bridge to transplantation. Two years later, he was hospitalized with the diagnosis of driveline infection. The blood cultures detected Pseudomonas aeruginosa. During the admission, he developed brain hemorrhage perhaps due to septic emboli. The chest computed tomography scan revealed a small defect inside the outflow graft of the DuraHeart, which was highly suspected of vegetation. He underwent pump exchange, from DuraHeart to Jarvik 2000 with concomitant omentopexy. His postoperative course was uneventful, and he was discharged with no sequela of the brain hemorrhage. Four months after the pump exchange, he successfully underwent heart transplantation. No infectious tissue was observed in the pericardial space at the time of heart transplantation. Pump exchange is an effective way to manage refractory left ventricular assist device infection, and the timing of surgical intervention is of great importance.
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Shun
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan. nawataka-sur@h.u-tokyo.ac.jp.
authors.forename: Kan
authors.initials: K
authors.lastname: Nawata
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kitahara
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Yoshitake
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Matsuoka
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Itoda
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Kinoshita
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Mitsutoshi
authors.initials: M
authors.lastname: Kimura
authors.affiliation: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Ono
mesh_terms: D006333:Heart Failure / Q000601:surgery*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011552:Pseudomonas Infections / Q000209:etiology* / Q000628:therapy; D011550:Pseudomonas aeruginosa / Q000302:isolation & purification
keywords: DuraHeart; Infection; Jarvik 2000; Left ventricular assist device; Pump exchange