Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis.

Abstract:

:No standardized treatment algorithm exists for the management of continuous-flow left ventricular assist device (CF-LVAD)-specific infections. The aim of this systematic review and meta-analysis was to compare the outcomes of CF-LVAD-specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF-LVAD-specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF-LVAD-specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF-LVAD exchange, and 140/158 (88.6%) patients were treated with non-exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow-up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3-50.6) vs. non-exchange 23.3% (15.8-32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7-58.0) vs. non-exchange 38.6% (15.4-68.5), P = 0.56]. In the setting of CF-LVAD-specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non-exchange modalities.

journal_name

Artif Organs

journal_title

Artificial organs

authors

Bauer TM,Choi JH,Luc JGY,Weber MP,Moncho Escrivá E,Patel S,Maynes EJ,Boyle AJ,Samuels LE,Entwistle JW,Morris RJ,Massey HT,Tchantchaleishvili V

doi

10.1111/aor.13378

subject

Has Abstract

pub_date

2019-05-01 00:00:00

pages

448-457

issue

5

eissn

0160-564X

issn

1525-1594

journal_volume

43

pub_type

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