Abstract
Objective Despite good results following implantation of left ventricular assist devices (LVADs),
infections of the driveline and device pocket remain a major problem for patients
on long-term support. We present the data from heart failure patients treated with
a Thoratec HeartMate-II LVAD (Thoratec Corporation, Pleasanton, California, United
States).
Methods From January 2008 to April 2011, in our institution, 40 heart failure patients (NYHA
IV) were supported with a HeartMate-II LVAD. The driveline maintenance of 17 patients
consisted of the use of Octenidine for the wound dressing, whereas merbromin was additionally
used for local irrigation in 31 patients. The data concerning driveline infections
were analyzed retrospectively.
Results In our study, 95% of the entire cohort was free from infections of the system. Two
patients in the conventional group (11.8%) developed a driveline infection at a mean
of 130.5 days during 3,416 patient-days (0.21 infection/patient-years). In the Merbromid
group (Co. New FaDem SRL Farmaceutici & Chimici, Giugliano, Campania, Italy), all
patients were free from any driveline infections during the observation period. In
a log-rank comparison, the difference reached statistical significance (p = 0.043).
Conclusion During our observation period, fewer infections were noted with merbromin treatment.
A multicenter setting in a larger cohort should be performed to confirm these findings,
although a (double-) blinded setting might be difficult to achieve.
Keywords
heart failure - left ventricular assist device - infections
