Left ventricular assist device infection is associated with increased mortality but is not a contraindication to transplantation

Left ventricular assist devices (LVADs) are increasingly used as a bridge to transplantation. Infection is a frequent and major complication associated with the use of these devices, however, the correlation of infection and outcome has not yet been evaluated in a prospective fashion. Twenty-five pa...

Full description

Saved in:
Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1997-02, Vol.95 (4), p.814-817
Main Authors: HERRMANN, M, WEYAND, M, GRESHAKE, B, VON EIFF, C, PROCTOR, R. A, SCHELD, H. H, PETERS, G
Format: Article
Language:English
Subjects:
Adult
Age Factors
Bacteria - isolation & purification
Bacterial Infections - epidemiology
Bacterial Infections - etiology
Biological and medical sciences
Candida albicans - isolation & purification
Candidiasis - epidemiology
Candidiasis - etiology
Cardiology. Vascular system
Contraindications
Female
Heart
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Heart Transplantation - mortality
Heart-Assist Devices - adverse effects
Humans
Male
Medical sciences
Middle Aged
Probability
Survival Rate
Time Factors
Ventricular Function, Left
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Left ventricular assist devices (LVADs) are increasingly used as a bridge to transplantation. Infection is a frequent and major complication associated with the use of these devices, however, the correlation of infection and outcome has not yet been evaluated in a prospective fashion. Twenty-five patients (24 male, 1 female) with end-stage cardiac failure and resulting organ dysfunction were included. Patients were bridged with the Novacor N100 portable LVAD (median duration of support, 55 days) and were evaluated prospectively by device surface cultures on explantation, molecular typing of isolates, and correlation of infection with survival to transplant. Twelve (48%) of 25 patients had LVAD infection as defined by recovery of multiple isolates of identical genotype from the device surface. Whereas only 5 (42%) of 12 patients with LVAD infection survived until transplantation, 11 (85%) of 13 patients without infection were successfully transplanted (P < .05). Death of the 7 patients with proven LVAD infection was associated with multiple organ failure or other signs of acute infection. LVAD infection is associated with a significantly decreased survival probability. It does not preclude successful bridging but rather may pose an indication for urgent transplantation.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.95.4.814