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driveline infection

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https://www.readbyqxmd.com/read/29731190/novel-driveline-route-for-prevention-from-driveline-infection-triple-tunnel-method
#1
Shuichi Yoshitake, Osamu Kinoshita, Kan Nawata, Yasuhiro Hoshino, Yoshifumi Itoda, Mitsutoshi Kimura, Haruo Yamauchi, Minoru Ono
BACKGROUND: The most prevalent and serious infection related to left ventricular assist devices (LVADs) is driveline infection (DLI). From 2014, we employed a revised surgical technique (triple tunnel method), which deployed a longer subfascial driveline (DL) route. METHODS AND PATIENTS: We retrospectively analyzed 34 patients fitted with either of the two types of axial pumps: HeartMate II (n=23) and Jarvik 2000 (n=11). Prior to 2014, the DL proceeded from the pump pocket just above the posterior sheath of the rectus muscle toward a vertical skin incision at the right lateral border of the rectus muscle...
May 3, 2018: Journal of Cardiology
https://www.readbyqxmd.com/read/29706098/effects-of-dicloxacillin-on-warfarin-dose-in-patients-with-a-left-ventricular-assist-device
#2
Kaitlyn M Buhlinger, Ian B Hollis
Patients with a durable, continuous flow left ventricular assist device (CF-LVAD) require anticoagulation with warfarin to prevent thromboembolic events. Driveline infections (DLIs) are a common CF-LVAD complication. A common pathogen implicated in DLI is oxacillin-sensitive Staphylococcus aureus (OSSA), which is effectively treated by oral dicloxacillin. Previous published experiences have observed a significant drug interaction between dicloxacillin and warfarin resulting in decreased international normalized ratio (INR) and increased warfarin dosing requirements...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29701352/two-years-of-experience-in-the-implantation-of-heartmate-iii
#3
Vítor Mendes, Candido Cerca, Monique Crosset, Matthias Kirsh
INTRODUCTION: Left ventricular assist devices as long-term mechanical circulatory support are increasingly used as an option for medically refractory advanced heart failure. Heartmate III is one of the alternative devices for circulatory support in those patients. OBJECTIVES: Analyze a two years Heartmate III implantation Program. METHODS: From November 2015 to August 2017, Heartmate III was implanted in 16 patients with chronic end-stage heart failure, in 81% (n = 13) as a bridge to transplant and 19% (n = 3) as destination therapy...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29675919/therapy-and-outcome-of-staphylococcus-aureus-infections-of-intracorporeal-ventricular-assist-devices
#4
Miquel B Ekkelenkamp, Mats T Vervoorn, Jumamurat R Bayjanov, Ad C Fluit, Barry J Benaissa-Trouw, Faiz Z Ramjankhan
Infection of the driveline or pump pocket is a common complication in patients with ventricular assist devices (VADs) and Staphylococcus aureus is the main pathogen causing such infections. Limited evidence is currently available to guide the choice of antibiotic therapy and the duration of treatment in these patients. Patients at the University Medical Center Utrecht who developed a VAD-related S. aureus infection between 2007 and 2016 were retrospectively assessed. Blood culture isolates were typed by whole genome sequencing to differentiate between relapses and reinfections, and to determine whether antibiotic therapy had led to acquisition of resistance mutations...
April 19, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29648627/late-outcomes-of-subcostal-exchange-of-the-heartmate-ii-left-ventricular-assist-device-a-word-of-caution
#5
Sarah N Yu, Hiroo Takayama, Jiho Han, Arthur R Garan, Paul Kurlansky, Melana Yuzefpolskaya, Paolo C Colombo, Yoshifumi Naka, Koji Takeda
OBJECTIVES: Previous studies have shown the usefulness of the subcostal exchange of the HeartMate II left ventricular assist device for device malfunction. However, long-term data are still limited. METHODS: Between March 2004 and July 2017, 41 of 568 (7.2%) patients who had received a HeartMate II implant at our institution had a device exchange via a subcostal incision. We summarized early and late outcomes. RESULTS: Forty-one patients had a total of 48 subcostal pump exchanges...
April 10, 2018: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29603408/effect-of-vitamin-d-level-on-clinical-outcomes-in-patients-undergoing-left-ventricular-assist-device-implantation
#6
Fadi Abou Obeid, Gardner Yost, Geetha Bhat, Erin Drever, Antone Tatooles
BACKGROUND: Vitamin D is an important hormone that regulates cardiac myocyte function. Low levels contribute to the development of cardiovascular disease and have been implicated in immune function and the inflammatory cascade. Patients who undergo left ventricular assist device (LVAD) implantation are at risk for driveline infection, stroke, and gastrointestinal (GI) bleeding. We investigated whether serum 25-hydroxy (25-OH) vitamin D levels affect clinical outcomes after LVAD. METHODS: 212 patients who underwent LVAD implantation between 2010 and 2015 were included...
March 30, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29550312/fdg-pet-ct-for-early-detection-and-localization-of-left-ventricular-assist-device-infection-impact-on-patient-management-and-outcome
#7
Jongho Kim, Erika D Feller, Wengen Chen, Yuanyuan Liang, Vasken Dilsizian
OBJECTIVES: The feasibility of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for the diagnosis of left ventricular assist device (LVAD) infection has been demonstrated. Beyond the diagnoses of LVAD infection, the authors hypothesized that the pattern and site of the infection along its various components may significantly impact clinical management and patient outcome. BACKGROUND: In patients with end-stage heart failure, the clinical use of LVAD for destination therapy is on the rise, accompanied by a higher prevalence of infections and serious complications...
March 9, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29433532/is-there-a-difference-in-bleeding-after-left-ventricular-assist-device-implant-centrifugal-versus-axial
#8
Ann C Gaffey, Carol W Chen, Jennifer J Chung, Jason Han, Christian A Bermudez, Joyce Wald, Pavan Atluri
BACKGROUND: Continuous-flow left ventricular assist devices (CF-LVAD) have become the standard of care for patients with end stage heart failure. Device reliability has increased, bringing the potential for VAD, compared to transplant, into debate. However, complications continue to limit VADs as first line therapy. Bleeding is a major morbidity. A debate exists as to the difference in bleeding profile between the major centrifugal and axial flow devices. We hypothesized that there would be similar adverse bleeding event profiles between the 2 major CF-LVADs...
February 13, 2018: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/29349805/hybrid-continuous-flow-total-artificial-heart
#9
Carson Fox, Steven Chopski, Nohra Murad, Paul Allaire, Robert Mentzer, Joseph Rossano, Francisco Arabia, Amy Throckmorton
Clinical studies using total artificial hearts (TAHs) have demonstrated that pediatric and adult patients derive quality-of-life benefits from this form of therapy. Two clinically-approved TAHs and other pumps under development, however, have design challenges and limitations, including thromboembolic events, neurologic impairment, infection risk due to large size and percutaneous drivelines, and lack of ambulation, to name a few. To address these limitations, we are developing a hybrid-design, continuous-flow, implantable or extracorporeal, magnetically-levitated TAH for pediatric and adult patients with heart failure...
January 18, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29340983/18f-fdg-pet-ct-imaging-of-left-ventricular-assist-device-infection-a-retrospective-quantitative-intrapatient-analysis
#10
Philipp Kanapinn, Wolfgang Burchert, Hermann Körperich, Jan Körfer
BACKGROUND: Despite the use of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), diagnosis of a driveline infection in ventricular assist device (LVAD) recipients remains challenging. Our aim was to evaluate the potential of a baseline 18F-FDG PET/CT (prior to an infection) for the diagnosis of an LVAD-related infection. METHODS: We retrospectively selected all LVAD recipients who had undergone two consecutive whole-body 18F-FDG PET/CT examinations between January 2010 and December 2016...
January 16, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29232297/long-term-success-with-driveline-exit-site-relocation-for-deep-driveline-infection-in-left-ventricular-assist-device-patients
#11
Leora B Balsam, Adam Jacoby, Eddie Louie, Jamie P Levine
OBJECTIVE: Driveline infection is a common complication of durable left ventricular assist device support. The majority involve the driveline exit site and can be treated with antibiotics and local wound care. Less frequently, these infections extend into deeper tissues and surgical debridement is necessary. Few studies have described the surgical strategy for treatment of deep driveline infection or have reported long-term outcomes. With a growing population of patients being implanted as destination therapy, there is an obvious need to evaluate and optimize treatment for complex driveline infections...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29206805/axial-to-centrifugal-continuous-flow-lvad-pump-exchange-using-minimally-invasive-technique
#12
Amit A Pawale, Ariel Farkash, Dimosthenis Pandis, Anelechi C Anyanwu
Driveline or device infection may complicate left ventricular assist device implants, and only curative option may be pump exchange. Replacement with similar device may be liable to reinfection, because pump configuration is such that the new device and driveline may partly lie within the pocket of the previous pump. One approach to overcome this is using a different pump design such that the new pump would lie in a different location from the old pump. We describe treatment of severe HeartMate II (Abbott, [St Jude Thoratec Corp], Pleasanton, CA USA) left ventricular assist device infection by minimally invasive exchange to an intrapericardial HVAD (HeartWare International, Inc, Framingham, MA USA) left ventricular assist device...
November 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29179901/ct-imaging-of-complications-associated-with-continuous-flow-left-ventricular-assist-devices-lvads
#13
Girish S Shroff, Daniel Ocazionez, Bindu Akkanti, Daniel Vargas, Alheli Garza, Pushpender Gupta, Jayeshkumar A Patel, Manish K Patel, Igor D Gregoric
Heart failure is becoming increasingly prevalent, and more patients are being treated with left ventricular assist devices (LVADs), either as a bridge to transplant or as destination therapy. The use of continuous-flow LVADs is on the rise. LVAD therapy is associated with several classes of complications, including bleeding, thrombosis, and infection. CT imaging can be used effectively to diagnose LVAD complications, including mediastinal hematomas and pericardial, abdominal wall, and retroperitoneal hemorrhage, inflow and outflow graft and aortic thrombi, and driveline and pump pocket infections...
December 2017: Seminars in Ultrasound, CT, and MR
https://www.readbyqxmd.com/read/29149978/perioperative-prophylaxis-for-total-artificial-heart-transplantation
#14
H E Chambers, P Pelish, F Qiu, D F Florescu
BACKGROUND: Practice variation regarding perioperative antimicrobial prophylaxis in total artificial heart transplantations (TAH-t) across institutions is unknown. The aim of our survey was to assess the current practices for prevention of infection in TAH-t recipients among different programs. METHODS: An electronic survey was sent to programs that implant Syncardia TAH (Syncardia Systems, Tuscon, Ariz, USA). Proportions were analyzed for categorical variables; means and SDs were analyzed for continuous variables...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29108083/-pedicled-omentum-flaps-in-the-management-of-deep-sternal-wound-infections
#15
Nick Spindler, Christian Etz, Martin Misfeld, Christoph Josten, Michael Borger, Friedrich Wilhelm Mohr, Stefan Langer
Aim Coverage of a deep sternal wound infection with a greater omentum flap. Due to a persistent infection caused by an infected aortic prosthesis, the primarily performed reconstruction with a latissimus dorsi flap had to be revised, and an alternative solution had to be found. Indication A deep sternal wound infection is a rare but devastating complication following median sternotomy. If the commonly used muscle flap is not sufficient and artificial material is still present in the wound, for instant drivelines or a vascular prosthesis, the greater omentum flap is a useful option due to its immunologic capacity...
November 6, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29098712/flap-coverage-for-the-treatment-of-exposed-left-ventricular-assist-device-lvad-hardware-and-intractable-lvad-infections
#16
Adam Jacoby, John T Stranix, Oriana Cohen, Eddie Louie, Leora B Balsam, Jamie P Levine
BACKGROUND: Left ventricular assist devices (LVADs) have become useful adjuncts in the treatment of patients with end-stage heart failure. LVAD implantation is associated with a unique set of problems; one such problem is device infection. We report our experience with flap salvage of infected and/or exposed LVAD hardware. METHODS: Between 2011 and 2016, 49 patients underwent LVAD implantation at our institution. Patients were then categorized by infectious status: systemic infection not directly involving the LVAD device, hardware infection responsive to antibiotics, and exposure of LVAD hardware or device infection refractory to antibiotics requiring debridement and flap coverage...
November 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/29095732/left-ventricular-assist-device-infections-a-systematic-review
#17
John C O'Horo, Omar M Abu Saleh, John M Stulak, Mark P Wilhelm, Larry M Baddour, M Rizwan Sohail
Left ventricular assist devices (LVADs) are becoming a more frequent life-support intervention. Gaining an understanding of risk factors for infection and management strategies is important for treating these patients. We conducted a systematic review and meta-analysis of studies describing infections in continuous-flow LVADs. We evaluated incidence, risk factors, associated microorganisms, and outcomes by type of device and patient characteristics. Our search identified 90 distinct studies that reported LVAD infections and outcomes...
October 31, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29076946/mapping-the-informed-consent-process-for-left-ventricular-assist-devices
#18
Savitri E Fedson, Kelly K MacKenzie, Estevan D Delgado, Mackenzie N Abraham, Jerry D Estep, Jennifer S Blumenthal-Barby, Courtenay R Bruce
Ethical, practical, and medical challenges affect decisions about left ventricular assist device (LVAD) implantation. The informed consent document (IC-Doc) is integral to the decision-making process and structures informed consent conversations. The objective of this study was to analyze IC-Docs to identify the information patients and their families receive about LVAD implantation to create a model IC-Doc. We requested IC-Doc for LVAD implantation from LVAD programs in the United States. We analyzed them in three areas: medical and technical content, patient knowledge gaps, and syntax...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29035899/driveline-site-is-not-a-predictor-of-infection-after-ventricular-assist-device-implantation
#19
Billie-Jean Martin, Jessica G Y Luc, Michiko Maruyama, Roderick MacArthur, Angela R Bates, Holger Buchholz, Darren H Freed, Jennifer Conway
Driveline infections (DLIs) remain a major source of morbidity for patients requiring long-term ventricular assist device (VAD) support. We aimed to assess whether VAD driveline exit site (DLES) (abdomen versus chest wall) is associated with DLI. All adult patients who underwent insertion of a HeartWare HVAD or HeartMate II (HMII) between 2009 and 2016 were included. Driveline infection was defined as clinical evidence of DLI accompanied by a positive bacterial swab and need for antibiotics. Competing risks analysis was used to assess the association between patient characteristics and DLI...
October 23, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28988400/left-ventricle-assist-devices-and-driveline-s-infection-incidence-a-single-centre-experience
#20
Jonida Bejko, Francesca Toto, Dario Gregori, Gino Gerosa, Tomaso Bottio
Different left ventricular assist devices (LVADs) are provided of different driveline exit sites: HeartWare HVAD presents abdominal power-cable-supply, while the Jarvik 2000 LVAD is powered by a retroauricular driveline. We analyzed 93 LVAD-implanted patients from January-2009 to October-2016 (41 HeartWare and 52 Jarvik 2000), hypothesizing a different incidence of infection, according to driveline exit site. The two populations were propensity matched for the demographic data and preoperative variables, and the outcomes were further analyzed...
March 2018: Journal of Artificial Organs: the Official Journal of the Japanese Society for Artificial Organs
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