Effectiveness of Pump Exchange for Major Device Related Infection in Patients Receiving a Durable Left Ventricular Assist Device
Recommended Citation
Shapiro S, Pienta M, Zhou S, Swaminathan S, Chandanabhumma P, Chenoweth C, Hawkins R, Cascino T, Aaronson K, Cowger JA, Malani P, Cabrera L, Likosky D, Pagani F. Effectiveness of Pump Exchange for Major Device Related Infection in Patients Receiving a Durable Left Ventricular Assist Device. J Heart Lung Transplant 2024; 43(4):S447.
Document Type
Conference Proceeding
Publication Date
4-1-2024
Publication Title
J Heart Lung Transplant
Abstract
Purpose: Purpose: Device-related infection (DRI) remains a major cause of morbidity and mortality following durable left ventricular assist device (dLVAD) implantation. Given limited data that informs the long term effectiveness of pump exchange for treatment of DRI, this study evaluated outcomes following pump exchange for DRI following dLVAD implantation. Methods: Methods: In this single center analysis, 49 patients were identified with DRI leading to dLVAD exchange (1/2007 - 12/2022). Major outcomes include survival, incidence of reinfection and proportion of patients free from reinfection 1-year following pump exchange. Results: Results: Median age was 49 years with 71% male and 57% White with 28.6% HeartMate 3, 57.1% HeartMate II, and 16.3% HVAD pumps. Median time from primary dLVAD implant to DRI diagnosis was 26 [7.8, 33.5] months. Time from DRI diagnosis to pump exchange was 4.1 [1.4, 10.1] months. Of the DRIs, 31 (63%) were localized to the percutaneous lead and 18 (37%) involved the pump pocket/component. The most common organism was Staphylococcus aureus (methicillin sensitive, N=17, 35%; methicillin resistant, N=5, 10%). Thirty (61%) patients underwent pump exchange alone and 19 (39%) underwent pump exchange with omental flap. Overall survival was 62.5+/-7.4% at 2-years following pump exchange. Freedom from reinfection at 1-year was 76% (N=37). The median time to DRI recurrence (N=18) was 5.8 [2.6, 14.7] months with 33% experiencing DRI after 12 months. Freedom from reinfection was obtained in 22/23 (96%) of patient whose time to pump exchange from DRI diagnosis was 3 months. Conclusion: Conclusion: While most patients achieve early success following pump exchange for DRI, the risk of DRI recurrence and mortality remains high. Early (
Volume
43
Issue
4
First Page
S447
