Preventive Strategies for Driveline Infections in Ventricular Assist Devices: A Systematic Review

Area of Science:

• Cardiology
• Infectious Diseases
• Medical Devices

Background:

• Driveline infection (DLI) is the most common infectious complication in ventricular assist device (VAD) patients.
• DLIs significantly contribute to patient morbidity and rehospitalization rates.

Purpose of the Study:

• To systematically review and synthesize evidence on strategies for preventing DLIs in adult VAD recipients.
• To identify effective preventive measures for reducing DLI incidence.

Main Methods:

• Systematic literature search across multiple databases (MEDLINE/PubMed, Scopus, CINAHL, Web of Science, Cochrane Library, APA PsycInfo) up to April 1, 2026.
• Adherence to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines.
• Inclusion of eleven observational studies evaluating various DLI prevention strategies.

Main Results:

• Surgical routing optimization, mechanical driveline stabilization, and standardized exit-site care protocols were consistently associated with lower DLI rates.
• Negative pressure wound therapy and prolonged antibiotic prophylaxis demonstrated limited or inconsistent benefits in reducing DLIs.
• Evidence primarily comes from observational studies, indicating a need for higher-quality research.

Conclusions:

• Optimizing surgical techniques and standardizing exit-site care are key to preventing DLIs in VAD patients.
• Further prospective and controlled studies are necessary to establish definitive, standardized preventive protocols.
• The findings underscore the importance of evidence-based practices in VAD care to minimize infectious complications.