Thorac Cardiovasc Surg 2015; 63(08): 670-674
DOI: 10.1055/s-0035-1554961
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Special Treatment and Wound Care of the Driveline Exit Site after Left Ventricular Assist Device Implantation

Ares K. Menon
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
*   Both authors contributed equally to the article.
,
Sophie-K. Baranski
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
*   Both authors contributed equally to the article.
,
Jan Unterkofler
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
,
Rüdiger Autschbach
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
,
Ajay K. Moza
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
,
Andreas Goetzenich
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
,
Lachmandath Tewarie
1   Department of Thoracic and Cardiovascular Surgery, University Hospital RWTH Aachen, Aachen, Germany
› Author Affiliations
Further Information

Publication History

02 February 2015

10 April 2015

Publication Date:
15 July 2015 (online)

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.

 
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