ISSN 2490-3329 (Print)
ISSN 2303-7954 (Online)

Volume 49, Issue 1, Article 9

(Scr Med 2018:49:57-60)
CASE STUDY

Surgical Treatment of the Left Ventricular Assist Device Drive Line Infection with Abscess Formation

Duško Terzic1, Emilija Nestorović1, Svetozar Putnik1, Saša Kačar1, Vladimir Jovičić1, Ana Janjić1, Miljko Ristić1

1 Department for Heart Transplant , LVAD and ECMO, Clinic for CardiacSurgery,Clinical Center of Serbia


doi: 10.18575/msrs.sm.e.18.09
UDC: 616.12-008.315-071
COBISS.RS-ID: 7318296


ABSTRACT

Specific left ventricular assist device infections are the leading cause of morbidity and second most common cause of death in patients who survive the first six months after implanting device, and also they are the most common cause of readmissions to hospital. The patient is a 63-year-old who received LVAD HeartMate II. The patient was readmitted to the hospital due to a driveline exit site infection and a developed abscess formation at 4 cm from the DL exit site. After reducing infection with antibiotics therapy, he was successfully operated by creating new exit site while removing the driveline from the infected region of the subcutaneous tissue. Repositioning of the driveline to a new exit site with mandatory removal of part of the driveline from the subcutaneous tissue in the region of infection, with extensive debridement of the wound is appropriate therapeutic option for patients with driveline infection.

Key words: drive line infection, LVAD, C shaped


Pdf version of article


Reference
1. Trachtenberg BH, Cordero-Reyes A, Elias B, et al. A review of infections in patients with left ventricular assist devices: prevention, diagnosis and management. Methodist DebakeyCardiovasc J 2015;11:28-32. https://doi.org/10.14797/mdcj-11-1-28  PMid:25793027 PMCid:PMC4362062
2. Topkara VK, Kondareddy S, Malik F, et al. Infectious complications in patients with left ventricular assist device: Etiology and outcomes in the continuous-flow era. Ann ThoracSurg 2010; 90: 1270–1277. https://doi.org/10.1016/j.athoracsur.2010.04.093  PMid:20868826    
3. Koval CE, Thuita L, Moazami N, et al. Evolution and impact of drive-line infection in a large cohort of continuous-flow ventricular assist device recipients. J Heart Lung Transplant 2014;33:1164-72. https://doi.org/10.1016/j.healun.2014.05.011  PMid:25034793    
4. Padera RF. Infection in ventricular assist devices: the role of biofilm. Cardiovasc Pathol. 2006 Sep–Oct;15(5):264–70. https://doi.org/10.1016/j.carpath.2006.04.008  PMid:16979033
5. Fleissner F, Avsar M, Malehsa D, Strueber M, Haverich A, Schmitto JD. Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices. Artif Organs. 2013 Jan;37(1):102–7. https://doi.org/10.1111/aor.12036 PMid:23305580    


Contact address:
Duško Terzić,
Clinic for Cardiac Surgery, Clinical
Center of Serbia
Street address: Koste Todorovića 8
11000 Belgrade, Serbia
e-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
phone number: +381-66-830-1966

Submitted: February 1st, 2018
Accepted: February 18th, 2018