Left Ventricular Assist Device-Associated Infections: Case Series

Abstract

AIM: We evaluate the epidemiological, laboratory, and clinical data of left ventricular assist device (LVAD)-associated infections diagnosed based on clinical evaluation, imaging studies, and microbiologic tests. BACKGROUND: A LVAD is a circulatory support device used in patients with end-stage heart failure; it is used either as a bridge to cardiac transplantation or as a long-term solution for those ineligible for transplantation. METHODS: This retrospective study analyzed four male patients older than 18 who were diagnosed with LVAD infections and free of comorbidities other than heart failure. The patients were treated at Samsun University Training and Research Hospital between January 2022 and July 2024. RESULTS: Wound and blood cultures obtained during the initial hospitalization revealed Meticillin-sensitive Staphylococcus aureus (MSSA), Methicillin-resistant Staphylococcus aureus (MRSA), and Pseudomonas aeruginosa. The patients reported fever (n = 3), drainage from the driveline exit site (n = 1), and erythema and pain at the exit site (n = 3). Surgical debridement and vacuum-assisted closure were performed at a previous hospital for one patient (Patient 1); no surgical treatment was considered necessary for the other patients. Three of the patients were readmitted during the course of the study (Patients 1, 2, and 4). Empirical antibiotic treatment was initiated for the suspected causative agent and later revised based on culture results. There were no mortalities. CONCLUSIONS: Left ventricular assist device infections significantly contribute to morbidity in recipients, and they often result in repeated hospital admissions. Empirical treatments can be guided by established guidelines and previous culture results.

Keywords

• LVAD,left ventricular assist device,morbidity,heart assist devices
• skin and soft tissue infections