Infections in patients after Berlin Heart^®EXCOR assist device implantation

Abstract

Infection complicated BHED implantation in 86.7% of the patients. Overall, 13.9% were specific of BHED and 22.2% were related. However, infections did not preclude HT in any case and carried no attributable mortality.

Long-term paracorporeal pulsatile mechanical circulatory support in adolescent and adult patients

“…The Berlin Heart EXCOR offers biventricular support as a bridge to a transplant or to recovery, especially in countries with long HTX waiting list times or fewer financial resources. The costs of a fully incorporeal VAD are listed as being up to 120,000 Euros compared to 20,000 Euros per ventricle chamber of the Berlin Heart EXCOR [ 11 ].…”

“…The study by Munoz et al was the first to focus on adult wound infections after a BIVAD implant. They included 15 adult patients and found 5 VAD-specific infections, with all their HTX patients developing at least 1 infection afterwards [ 11 ]. We could not identify wound infections to be an independent risk factor for mortality after an HTX nor did they preclude an HTX.…”

“…Antibiotic treatment was given to treat elevated white blood cell counts, C-reactive protein levels or temperatures as well as after proof of pathological infectious agents at the cannulas. Munoz et al reported an overall post-HTX mortality of 40% in their cohort with no death attributable to a wound infection [ 11 ]. Pump exchanges were necessary for pump thrombosis in 48.3% of our patients, in whom we noticed an increasing rate with longer BIVAD support times.…”

Wound Infections in Adult Patients after Berlin Heart® EXCOR Biventricular Assist Device Implantation

“…In other recent studies of adult Berlin Heart ® EXCOR patients, VAD-S infections occurred in 14–33.3% after implantation. However, not all devices were used in a biventricular configuration [ 7 , 11 , 20 ]. Herein, VAD-specific (cannula) WI appeared at a higher rate than in other studies (53.4%).…”

“…The main complications under VAD support include bleeding, thrombosis, and infections [ 9 ]. Infection rates in previous VAD studies vary from 18% to 59% [ 10 , 11 , 12 ]. Non-VAD-related infections, including pneumonia, bloodstream infections, urinary tract infections, and gastrointestinal infections, have been the leading category of infection in mechanical circulatory support (MCS) patients, followed by VAD-specific infections, mainly including driveline infections (80%) [ 13 , 14 ].…”