Table 8: Infection with Mechanical Ventricular Assist Devices.
| Study | Sample Size n | Device | Total Infection Rate | LVAD related infection rate | Sepsis | Infection mortality |
|---|---|---|---|---|---|---|
| Vitali 200344 | 53 | mixed | LVAD related endocarditis 1.8% Pocket infection 3.77% Driveline exit site infection 3.77% |
5.6% | 0 | |
| Granfeldt 200345 | 59 | Mainly Heartmate® | 44% | Driveline or exit site 15.2% Valve endocarditis 5/59 |
- | - |
| Malani 200239 | 35 | Surgical site infection 46% (16) Deep tissue infection 9/16 Pneumonia (7), venous infection (6), blood stream (2), urinary tract (3), skin/soft tissue (2) |
- | - | ||
| Navia 2002 | 264 | 6 months | Cumulative infection rate = 1.88/patient @ 6 months Blood stream infection 1.07 infections/patient Driveline infection 0.94 infection/patient Pocket infection 0.49 infection/patient |
- | - | |
| Gordon 200141 | 214 | Attack rate of blood stream infection 49%. LVAD related BSI 38% Coagulase negative staph 33 Staph. Aureus 19 Candida 19, Psuedomonas aeruginosa |
- | - | ||
| Frazier 200120 | 280 | HeartMate® 1 year |
45% | LVAD related 40% | - | - |
| Grossi, 200146 | 43 | Novacor® | 72% (severe 52.6%) | Bacteremia 34% (26 episodes) Urinary tract infection 18.4% (14 episodes0 Drive line exit 14.5% (11episodes) Tracheobronchitis 9.2% (7 episodes) Device pocket 2.6% (2episodes) Pneumonia 1.3 episodes (1episode) 10 patients successful transplant during anti-infection treatment. No patient developed same infection after transplantation |
4% | - |
| Bank, 2000 | 20 | HeartMate® | 45% | |||
| Helman, 200047 | 12 (< 21 yrs) | HeartMate® | Systemic infection 33% of patients. | - | - | |
| Sinha 2000 | 86 | HeartMate VE® | 66% had =/>1 | LVAD related infection 17% LVAD endocarditis 8% (2 cases fatal) A high incidence of infection during LVAD support did not have an impact on pre-transplant or post-transplant mortality, post-transplant infection rate or overall patient survival. |
5.8% | 5.8% |
| Sun, 1999 | 95 | HeartMate® | 54% | LVAD related infection = 27% Drive line: 16% Pocket: 2% Endocarditis: 9% |
- | 10% of infections, 5% of all patients |
| McCarthy48 1999 | 97 | HeartMate® | 59% | Drive line infection: 28% Pump infection: 11% 28+11 = 39% |
- | - |
| Oz, 199742 | 58 | HeartMate® | 53% | Driveline: 14% (7 - 20%) Endocarditis 14% |
- | - |
| Griffith, 1996 | 162 | HeartMate® | Driveline: 33% (54/162), major in 24 cases (44%) Other infections: 45% (73/162) |
- | - | |
| El -Banayosy, 200149 | 144 | Novacor® HeartMate® Thoratec® |
Driveline Exit site: Novacor: 24%, Heartmate: 30%, Thoratec: 9% (9-30%) Pocket Infection: N: 7%, H: 21% |
11 - 13% | 32% of infection (14% of all patients) |
|
| Meyns 20028 | 165 | Novacor® ABIOMED ® | 6% | - | - | |
| Loisance, 200050 | 36 | Novacor®® | Overall freedom from infection: 75% at 1 year, 67% at 1.5 yeas and 58% at 2 years. Most significant Staph. Aureus | - | - | |
| Holman 200234 | 46 (53 devices) | Thoratec® HeartMate® |
Device infection 20% | 11% | 11% mortality due to sepsis | |
| Novacor 1998 | Novacor® | 66% | ||||
| Bentz 200443 | 90 | Thoratec ® HeartMat® |
Overall device related 20% | Thoratec 10%, HeartMate 29% Staphlococcus found in 61.9% of device related infection; Driveline 52.1%(31% pocket, 15% VAD); 16/18 with LVAD related infection were successfully transplanted |