title: Successful management of apical abscess after Nipro left ventricular assisted device explantation by removal of apical cuff and omentopexy.
abstract: Nipro-Toyobo-paracorporeal pulsatile flow VAD (Nipro VAD; Nipro, Osaka, Japan) has been used most commonly as a paracorporeal VAD (p-VAD) in Japan. There are few reports describing clinical course of post LVAD explantation and its complication. We herein present two cases of apical abscess after the explantation of the device. SSI is a main risk factor of formation of the apical abscess at the time of LVAD explantation. It is mandatory to perform sufficient debridement and closure of the layers including abdominal muscle and anterior abdominal fascia at exit sites in the explantation surgery. Omentopexy is also helpful for prevention from infection. Routine removal of apical cuff and outflow graft could be considered as one of the options when LVAD is explanted as bridge to recovery.
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. a1mb1100-thk@umin.ac.jp.
authors: Shuichi
authors: S
authors: Yoshitake
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Yoshifumi
authors: Y
authors: Itoda
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Kan
authors: K
authors: Nawata
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Tomoyuki
authors: T
authors: Iwase
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Yasuhiro
authors: Y
authors: Hoshino
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Mitsutoshi
authors: M
authors: Kimura
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Osamu
authors: O
authors: Kinoshita
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors: Haruo
authors: H
authors: Yamauchi
authors: Department of Cardiac Surgery, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. ono-tho@h.u-tokyo.ac.jp.|Department of Cooperative Unit of Medicine and Engineering Research, The University of Tokyo, Tokyo, Japan. ono-tho@h.u-tokyo.ac.jp.
authors: Minoru
authors: M
authors: Ono
mesh_terms: D000038:Abscess / Q000209:etiology* / Q000601:surgery; D000328:Adult; D020878:Device Removal; D006333:Heart Failure / Q000601:surgery; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009852:Omentum / Q000601:surgery; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000209:etiology* / Q000601:surgery
keywords: Apical abscess; LVAD explantation; Nipro VAD; Surgical site infection