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Infectious complications in left ventricular assist device recipients
S A Fischer1, G M Trenholme, M R Costanzo
1Section of Infectious Disease, Rush Medical College, Chicago, Illinois, USA.
Summary
Left ventricular assist device (LVAD) infections in heart failure patients can be successfully treated with antibiotics, allowing for subsequent heart transplantation without device removal or infection recurrence.
Area of Science:
- Cardiology
- Infectious Diseases
- Medical Devices
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure patients awaiting transplantation.
- LVAD implantation is associated with significant infection risks, yet management strategies and outcomes remain understudied.
Observation:
- Infections developed in 40% of the initial 20 LVAD recipients.
- Three patients (15%) experienced LVAD-related bloodstream infections, caused by Staphylococcus aureus and Candida tropicalis.
Findings:
- All infected patients received prolonged antibiotic therapy (≥6 weeks) suitable for prosthetic valve endocarditis.
- Successful cardiac transplantation was achieved in all three infected patients.
- No evidence of infection recurrence was observed up to 16 months post-transplantation.
Implications:
- LVAD-related infections are treatable without device explantation.
- Cardiac transplantation is a viable option for patients with LVAD bloodstream infections.
- This study provides evidence for managing LVAD infections and their impact on transplant candidacy.