Frequency and significance of infections in patients receiving prolonged LVAD support

Infections in patients undergoing mechanical circulatory support as a bridge to transplant are associated with significant mortality and morbidity. To determine the frequency and effects of infection during such procedures, a retrospective analysis was done of 14 patients who received prolonged (greater than 14 days) support with the Heartmate left ventricular assist device (LVAD) (Thermo Cardiosystems, Inc., Woburn, MA). All patients were men (mean age, 44.3 years), and duration of LVAD support ranged from 19 to 233 days (mean, 98.1 days). During LVAD support, five patients had no infections, and, in the remaining nine patients, infections were most common in the respiratory tract, catheter tips, and urine. Four device related infections occurred in three patients, all of which were resolved with antibiotic therapy. All 14 patients underwent transplantations, and none of the operations was delayed because of infection. Eleven of the patients are long-term survivors (range of time after transplant, 7.5-37 months). Infections were not associated with mortality or significant morbidity in this group of patients.