Continuous-flow left ventricular assist devices and usefulness of a standardized strategy to reduce drive-line infections

Cagliostro, B.; Levin, A.P.; Fried, Justin; Stewart, Scott A.; Parkis, G.; Mody, Kanika; Garan, A.R.; Topkara, V.K.; Takayama, Hiroo; Naka, Yoshifumi; Jorde, Ulrich P.; Uriel, Nir

doi:10.1016/j.healun.2015.06.010

Cited by 69 publications

(63 citation statements)

References 19 publications

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“…Cagliostro et al reported a reduction in driveline infection rate achieved by the implementation of a standardized kit for driveline care, which included silver dressing and a standard anchoring device, but median follow‐up did not reach one year …”

Section: Discussionmentioning

confidence: 99%

Surgical management of driveline infections in patients with left ventricular assist devices

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Surgical management of driveline infections in patients with left ventricular assist devices

et al. 2016

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“…Ultrasound or computed tomography scans may be necessary to reveal ascending driveline or pump pocket infections. New strategies to prevent driveline infections appear to reduce the risk significantly, as recently demonstrated . While the incidence of exit site driveline infections appears to have decreased, other important complications have remained reasonably stable over time.…”

Section: Outcomementioning

confidence: 99%

Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes

Gustafsson

Rogers

2017

European J of Heart Fail

249

193

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Despite improvements in pharmacological therapy and pacing, prognosis in advanced heart failure (HF) remains poor, with a 1-year mortality of 25-50%. While heart transplantation provides excellent survival and quality of life for eligible patients, only a few can be offered this treatment due to shortage of donor organs. Implantable left ventricular assist device (LVAD) technology has improved considerably, and the currently used continuous flow devices may last >10 years in a patient. LVADs are being used increasingly both as bridge-to-transplantation and as destination therapy. Current studies report 1- and 2-year survival after LVAD implantation of 80% and 70%, respectively. Outcome after LVAD implantation in stable patients is superior to that of 'crash and burn' patients or patients sliding on inotropes, favouring early referral and implantation. This review summarizes factors to consider when deciding on LVAD implantation such as age, co-morbidity, and cardiac pathophysiology. Complications to LVAD therapy are reviewed. It is concluded that while complications with LVAD therapy are not uncommon, most are manageable, and current outcomes clearly justify use of LVADs in advanced HF.

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“…13 Driveline care kits were demonstrated to be easy to use by the vast majority of LVAD patients and resulted in lower rates of driveline infection. 13,14 External power supply needs may limit mobility. A pair of batteries for the Heartmate 3 LVAD offers up to 17 hours of uninterrupted support and allows for independence outdoors.…”

Section: What Are the Components Of An Lvad?mentioning

confidence: 99%

Left Ventricular Assist Device Therapy in Older Adults: Addressing Common Clinical Questions

DeFilippis

Nakagawa

Maurer

et al. 2019

J American Geriatrics Society

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OBJECTIVES To review the literature and summarize the evidence for left ventricular assist device (LVAD) use in older adults (aged >75 years), highlighting patient selection, day‐to‐day life with an LVAD, age‐specific complications, and end‐of‐life considerations. DESIGN Contemporary review of current literature on LVAD therapy in older adults. RESULTS There is a paucity of data on LVAD use and outcomes in adults older than 75 years and even less commonly are such devices implanted in those older than 80 years. Candidates and recipients of this age often have multiple chronic conditions and extracardiac impairments, which can negatively affect their short‐term outcomes and daily experience following LVAD implantation. Therefore, selection prior to implant should incorporate end‐organ function, nutritional status, measures of frailty, neurocognitive status, and social support, among others, to determine the patient population most likely to benefit from such therapy. CONCLUSION When LVAD therapy is utilized in an older adult, the needs for multidisciplinary team management and expertise in palliative care are essential. More age‐specific outcome data are required to help inform providers, patients, and caregivers. J Am Geriatr Soc 67:2410–2419, 2019

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Continuous-flow left ventricular assist devices and usefulness of a standardized strategy to reduce drive-line infections

Cited by 69 publications

References 19 publications

Surgical management of driveline infections in patients with left ventricular assist devices

Surgical management of driveline infections in patients with left ventricular assist devices

Left ventricular assist device therapy in advanced heart failure: patient selection and outcomes

Left Ventricular Assist Device Therapy in Older Adults: Addressing Common Clinical Questions

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