Current concepts in the diagnosis and management of left ventricular assist device infections

Juhsien Nienaber, Mark P. Wilhelm, M. Rizwan Sohail

Research output: Contribution to journalReview article

40 Scopus citations

Abstract

Left ventricular assist devices (LVAD) are increasingly being used both as a bridge to transplantation and for long-term myocardial surrogate destination therapy in patients with end-stage heart failure. Primarily owing to the presence of a driveline that connects the device to an external battery through an open skin incision, the rates of LVAD-related infections (LVADRIs) are high, ranging from 30 to 50%. LVADRIs can be broadly classified into driveline infection, pump pocket infection, bloodstream infection and endocarditis/pump or cannula infection. Diagnostic evaluation and management of these complicated infections can be quite challenging for clinicians involved in the care of these patients. Here, the authors summarize the current epidemiology, microbiology, diagnostic approach and management strategies for each type of LVADRI. The authors also review current concepts regarding antibiotic prophylaxis for LVAD implantation. Finally, the authors highlight the gaps in the knowledge of LVADRI and provide directions for future studies.

Original languageEnglish (US)
Pages (from-to)201-210
Number of pages10
JournalExpert Review of Anti-Infective Therapy
Volume11
Issue number2
DOIs
StatePublished - Feb 1 2013

Keywords

  • bloodstream infection
  • diagnosis
  • driveline
  • endocarditis
  • heart failure
  • infection
  • left ventricular assist device
  • management
  • microbiology
  • pump pocket

ASJC Scopus subject areas

  • Microbiology
  • Microbiology (medical)
  • Virology
  • Infectious Diseases

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