Driveline Infection Risk with Utilization of a Temporary External Anchoring Suture After Implantation of a Left Ventricular Assist Device.

Published

Journal Article

Driveline infections (DLI) are a cause of morbidity after continuous-flow left ventricular assist device (CF-LVAD) implantation. Because driveline trauma contributes to DLI, we assessed whether intraoperative placement of a temporary external anchoring suture (EAS) influenced DLI rate. We analyzed 161 consecutive patients with CF-LVAD (HMII 82; HW 79) implantation. Two groups were defined: placement of EAS (n = 85) or No EAS (n = 76). For NO EAS patients, the driveline was permanently anchored internally to the rectus fascia. Cox proportional analysis was performed to assess the effect of EAS on time to first confirmed DLI. Baseline characteristics were comparable between groups (all p = 0.3). Mean follow-up time was 0.93 years. A total of 18 (11.1%) patients developed confirmed culture positive DLI, with "first infection" rate of 0.13 events/year. Mean time to confirmed DLI was 0.69 years. Driveline infection was less likely (hazard ratio [HR] = 0.28, 0.95 confidence interval [CI] = 0.06-1.25, p = 0.056) to occur in NO EAS (2/18) then in EAS (16/18). Confirmed DLI was comparable between device types (p = 0.3). Multivariable regression adjusted for age, BMI, blood product use, device type, and diabetes showed equivocal effect of EAS (HR = 0.33, 0.95 CI = 0.07-1.54, p = 0.12). Patients with a temporary EAS may have an increased risk of confirmed DLI after device implantation.

Full Text

Duke Authors

Cited Authors

  • Fudim, M; Brown, CL; Davis, ME; Djunaidi, M; Danter, MR; Harrell, FE; Stulak, JM; Haglund, NA; Maltais, S

Published Date

  • May 2016

Published In

Volume / Issue

  • 62 / 3

Start / End Page

  • 291 - 296

PubMed ID

  • 26809083

Pubmed Central ID

  • 26809083

Electronic International Standard Serial Number (EISSN)

  • 1538-943X

International Standard Serial Number (ISSN)

  • 1058-2916

Digital Object Identifier (DOI)

  • 10.1097/mat.0000000000000346

Language

  • eng