Reduction of driveline infections through doubled driveline tunneling of left ventricular assist devices.

Abstract:

:The durability of ventricular assist device (VAD) therapy improved steadily over the past years. However, driveline infections remain a challenge. To test whether an improved surgical implantation technique may lower the incidence of infections, we analyzed all patients receiving a VAD implantation in the years 2008 and 2009 (group 1) and compared them with all patients who received a VAD in 2011 (group 2) after we changed our implantation method. The new technique involves tunneling of the driveline into the fascia of the musculus rectus abdominis, resulting in a longer, intrafascial run to achieve a better resistance against ascending infections. We retrospectively analyzed 40 patients in group 1 and 41 patients in group 2. One year after implantation, the infection rate was markedly reduced (22.5% [n = 9] group 1 vs. 4.9% [n = 2] group 2, P < 0.001) by the new implantation method. There was, however, no significant improvement in overall mortality. The Cox regression model identified the implantation method as an independent risk factor for 1 year after implantation driveline infection (P < 0.05). In conclusion, the new tunneling technique marks a great leap forward in long-term VAD treatment. However, overall mortality remains high and needs further improvement.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Fleissner F,Avsar M,Malehsa D,Strueber M,Haverich A,Schmitto JD

doi

10.1111/aor.12036

subject

Has Abstract

pub_date

2013-01-01 00:00:00

pages

102-7

issue

1

eissn

0160-564X

issn

1525-1594

journal_volume

37

pub_type

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