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Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series

Driveline infection is one of the most frequent complications following left ventricular assist device (LVAD) treatment and there is no consensus for its management. The standard approach to treat foreign-body infection is complete device ablation, which is not always feasible and therefore not an e...

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Autores principales: Cikirikcioglu, Mustafa, Ponchant, Kevin, Murith, Nicolas, Meyer, Philippe, Yilmaz, Nurcan, Huber, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559168/
https://www.ncbi.nlm.nih.gov/pubmed/34558333
http://dx.doi.org/10.1177/03913988211047250
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author Cikirikcioglu, Mustafa
Ponchant, Kevin
Murith, Nicolas
Meyer, Philippe
Yilmaz, Nurcan
Huber, Christoph
author_facet Cikirikcioglu, Mustafa
Ponchant, Kevin
Murith, Nicolas
Meyer, Philippe
Yilmaz, Nurcan
Huber, Christoph
author_sort Cikirikcioglu, Mustafa
collection PubMed
description Driveline infection is one of the most frequent complications following left ventricular assist device (LVAD) treatment and there is no consensus for its management. The standard approach to treat foreign-body infection is complete device ablation, which is not always feasible and therefore not an elected method for LVAD driveline infections. Here we share the results from a series of cases successfully treated for driveline infection by negative pressure wound therapy (NPWT) therapy. Between 2016 and 2020, five male patients were hospitalized in our unit with a driveline infection of HeartMate III-LVAD(®). Ultrasonography and/or thoraco-abdominal CT confirmed the diagnosis, infection localization, and abscess formation. Following an antibiotic treatment, an urgent surgical abscess drainage and debridement of the infected tissues were performed. At the end of the procedure, NPWT was applied. NPWT re-dressing and debridement of wound was performed every 3–4 days. The wound was closed surgically after obtaining negative culture results and good healing. The patients were discharged in good condition, without signs of infection. Two patients underwent successful heart transplantation after 1 and 13 months. Other patients did not show any residual or recurrent infection during the follow-up within 25 months. Driveline infection following LVAD implantation is a significant complication and a challenging in terms of management for both; the surgical team and the patient. These results from our case series report a successful and less invasive approach by using NPWT for the treatment of LVAD driveline infections.
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spelling pubmed-85591682021-11-02 Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series Cikirikcioglu, Mustafa Ponchant, Kevin Murith, Nicolas Meyer, Philippe Yilmaz, Nurcan Huber, Christoph Int J Artif Organs Short Communication Driveline infection is one of the most frequent complications following left ventricular assist device (LVAD) treatment and there is no consensus for its management. The standard approach to treat foreign-body infection is complete device ablation, which is not always feasible and therefore not an elected method for LVAD driveline infections. Here we share the results from a series of cases successfully treated for driveline infection by negative pressure wound therapy (NPWT) therapy. Between 2016 and 2020, five male patients were hospitalized in our unit with a driveline infection of HeartMate III-LVAD(®). Ultrasonography and/or thoraco-abdominal CT confirmed the diagnosis, infection localization, and abscess formation. Following an antibiotic treatment, an urgent surgical abscess drainage and debridement of the infected tissues were performed. At the end of the procedure, NPWT was applied. NPWT re-dressing and debridement of wound was performed every 3–4 days. The wound was closed surgically after obtaining negative culture results and good healing. The patients were discharged in good condition, without signs of infection. Two patients underwent successful heart transplantation after 1 and 13 months. Other patients did not show any residual or recurrent infection during the follow-up within 25 months. Driveline infection following LVAD implantation is a significant complication and a challenging in terms of management for both; the surgical team and the patient. These results from our case series report a successful and less invasive approach by using NPWT for the treatment of LVAD driveline infections. SAGE Publications 2021-09-24 2021-11 /pmc/articles/PMC8559168/ /pubmed/34558333 http://dx.doi.org/10.1177/03913988211047250 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Short Communication
Cikirikcioglu, Mustafa
Ponchant, Kevin
Murith, Nicolas
Meyer, Philippe
Yilmaz, Nurcan
Huber, Christoph
Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title_full Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title_fullStr Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title_full_unstemmed Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title_short Treatment of HeartMate III–LVAD driveline infection by negative pressure wound therapy: Result of our case series
title_sort treatment of heartmate iii–lvad driveline infection by negative pressure wound therapy: result of our case series
topic Short Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8559168/
https://www.ncbi.nlm.nih.gov/pubmed/34558333
http://dx.doi.org/10.1177/03913988211047250
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