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A novel problem, a tested solution: A case of an infected left ventricular titanium plug
Sachin Teelucksingh1, Stephen Schueler2, Timothy P Crowley1
1Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
Journal of Cardiac Surgery
|August 14, 2020
Summary
Persistent left ventricular assist device infections are difficult to manage. This case highlights a novel surgical technique using a latissimus dorsi flap to treat a rare infected titanium plug, improving patient outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Surgical Innovation
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure.
- Persistent LVAD infections pose significant treatment challenges.
- Sarcoid myocarditis can lead to severe heart failure requiring LVAD support.
Observation:
- A middle-aged man with sarcoid myocarditis developed cardiogenic shock requiring LVAD placement.
- Following LVAD decommissioning, infection occurred in the implant bed, chest wall, and titanium plug.
- This is the first reported case of an infected LVAD titanium plug.
Findings:
- Successful treatment of the infected titanium plug was achieved using a latissimus dorsi flap.
- The vascularized flap provided robust tissue coverage and eradicated the infection.
- A multidisciplinary approach was essential for managing this complex case.
Implications:
- This case demonstrates a viable surgical option for infected LVAD titanium plugs.
- Latissimus dorsi flap reconstruction offers a potential solution for challenging implant site infections.
- Effective management of LVAD infections requires a collaborative, interdisciplinary strategy.
Keywords:
cardiovascular pathology
