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Aspergillus left ventricular assist device endocarditis.

Alessandro Barbone1, Daniela Pini, Paolo Grossi

  • 1Cardiac Surgery, Istituto Clinico Humanitas, Rozzano (MI), Italy. alessandro.barbone@unimi.it

Italian Heart Journal : Official Journal of the Italian Federation of Cardiology
|January 7, 2005
PubMed
Summary
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Fungal infection of a left ventricular assist device (LVAD) caused fatal sepsis and valve malfunction in a destination therapy patient. Early suspicion and antifungal treatment are crucial for managing this deadly complication in LVAD recipients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Medical Devices

Background:

  • Left ventricular assist device (LVAD) therapy is established for heart failure bridge-to-transplant.
  • Destination therapy (DT) for non-transplant candidates is less established.
  • LVAD infections contribute significantly to mortality.

Observation:

  • A 68-year-old male received a Thoratec-Heartmate LVAD for DT.
  • Post-implantation, the patient developed intractable fever and sepsis.
  • Death occurred 21 days post-implant due to severe LVAD valve malfunction.

Findings:

  • Post-mortem examination revealed fungal hyphae on LVAD inflow and outflow valves.
  • This indicates fungal LVAD endocarditis, a severe complication.
  • White blood cell counts remained within normal limits, masking infection.

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Implications:

  • Fungal LVAD endocarditis is a particularly deadly complication.
  • Prompt diagnosis and antifungal therapy are essential for management.
  • Empiric antifungal therapy may be warranted for LVAD recipients with culture-negative sepsis.