Infections Following Total Artificial Heart Placement
Year: 2015
Type: article
Study design: Case Report
Abstract: Background. The Syncardia total artificial heart (TAH) provides biventricular replacement and is being used with increasing frequency as a bridge to orthotopic heart transplant (OHT). Immunologic changes after ventricular assist device placement have been described and may alter the risk of infections. Methods. Six adult cases since 2012 were reviewed to explore infections in the setting of TAH. Infections were defined as a positive culture or new physical finding. Due to widespread abnormalities on chest imaging, pneumonias were excluded in the absence of a documented pathogen. Results. Mean age was 46.7 and all cases were male. Indications for TAH included cardiac allograft vasculopathy and rejection (n = 3) and ischemic and non-ischemic cardiomyopathy (n = 3). Infection incidence was 100%, with a mean time to first infection of 59 days after TAH placement (range 12–112 days). Three cases developed >1 infection and 3 cases had a single infection. All patients received broad-spectrum antibiotics at the time of TAH placement. Three cases survived to OHT and 2 are awaiting OHT. One case suffered embolic strokes at days 11 and 43 after TAH and died. Conclusion. Persons who are TAH-dependent are at risk for the development of diverse infections, including both community-acquired and nosocomial pathogens. As opposed to the localized drive-line and pocket site infections seen with other ventricular assist devices, TAH-dependent persons developed infections at multiple sites. Controlled studies are needed as well as further investigation into the immunologic impact of device implantation. Disclosures. J. Lake, Gilead Sciences: Consultant, Consulting fee. GlaxoSmithKline: Consultant and Investigator, Consulting fee and Research support.
Source: Open Forum Infectious Diseases
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: gold
Estimated APC paid: $4,053
OpenAlex ID: W2404640381