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Ventricular Assist Device Driveline Infections: A Systematic Review
Kristina Krzelj1, Mate Petricevic2, Hrvoje Gasparovic1,3
1Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia.
The Thoracic and Cardiovascular Surgeon
|September 14, 2021
Summary
Ventricular assist device (VAD) driveline exit site infections are common complications. Prevention strategies like sterile dressing changes and patient education are crucial for managing these infections.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Infection is a frequent complication following ventricular assist device (VAD) implantation.
- Driveline exit site (DLES) infection is the most common VAD-related infection, leading to significant morbidity, mortality, and hospital readmissions.
- Risk factors for driveline infection (DLI) are diverse, including patient characteristics, device factors, and comorbidities.
Purpose of the Study:
- To provide a comprehensive synthesis of current data on the prevention, diagnosis, and management of DLI in VAD patients.
- To highlight the importance of standardized DLES care and patient education in DLI prevention.
- To review diagnostic challenges and treatment options for DLI.
Main Methods:
- Systematic review of recent data.
- Synthesis of information on DLI prevention, diagnosis, and management.
- Analysis of risk factors and treatment modalities.
Main Results:
- DLI is a significant complication with numerous contributing risk factors.
- Effective prevention likely involves uniform DLES care, including immobilization, sterile dressing kits, and patient education.
- Diagnosis and treatment are challenging due to immunological changes and biofilm formation.
- Heart transplantation remains the only definitive solution for DLI resolution.
Conclusions:
- DLI is a major concern in VAD patients requiring multifaceted management strategies.
- Standardized DLES care and patient education are critical for DLI prevention.
- Further research may be needed to optimize diagnostic and therapeutic approaches beyond heart transplantation.
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