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Infectious Concerns and Prevention for Patients with Ventricular Assist Devices

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A Guide to Mechanical Circulatory Support

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Abstract

Left ventricular assist devices (LVAD) are surgically implanted as a treatment option for advanced heart failure but are not without complications. While the previous chapter discusses complications related to LVADs, this chapter will focus on infectious concerns. Prevalence of infection in durable LVADs occurs in up to 60% of recipients with driveline exit site (DLES) infections being most common (Raymond et al., ASAIO J 56:57–60, 2010; Goldstein et al., J Heart Lung Transplant 31:1151–7, 2012). Many factors contribute to infectious issues such as implantation technique, device choice, patient selection, comorbidities, duration of the device in use, and changes in pump design over time. Infections are costly and lead to readmissions, longer hospital stays, the need for long-term antibiotics, possibly surgery, stroke, and death (Simon et al., Clin Infect Dis 40:1108–15, 2005; Martin et al., Interact Cardiovasc Thorac Surg 11:20–3, 2010). Patients with device infection carry a 70% risk of 1-year mortality (Topkara et al., Ann Thorac Surg 90:1270–77, 2010). Infectious workup is part of patient selection and comorbidity risk factors should be considered such as poor nutrition, obesity, diabetes mellitus, chronic kidney disease, younger age, or poor dentition with periodontitis and abscesses (Raymond et al., ASAIO J 56:57–60, 2010; Goldstein et al., J Heart Lung Transplant 31:1151–7, 2012; Martin et al., Interact Cardiovasc Thorac Surg 11:20–3, 2010; Kamdar et al., J Heart Lung Transplant 31:S19–20, 2012) (see Table 2).

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Authors and Affiliations

  1. Sharp Medical Center, San Diego, CA, USA

    Marcia Stahovich

  2. Ochsner Hospital, Jefferson, LA, USA

    Krista Marz

  3. Scripps La Jolla, La Jolla, CA, USA

    Jennifer Nowaczyk

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  1. Hackensack University Medical Center, Hackensack, NJ, USA

    Scott Stewart

  2. UAB Hospital, University of Alabama at Birmingham, Birmingham, AL, USA

    Peggy Blood

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Stahovich, M., Marz, K., Nowaczyk, J. (2022). Infectious Concerns and Prevention for Patients with Ventricular Assist Devices. In: Stewart, S., Blood, P. (eds) A Guide to Mechanical Circulatory Support. Springer, Cham. https://doi.org/10.1007/978-3-031-05713-7_8

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  • DOI: https://doi.org/10.1007/978-3-031-05713-7_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-05712-0

  • Online ISBN: 978-3-031-05713-7

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