Impact of HeartMate 3 left ventricular assist device infection on outcomes following heart transplant.

BACKGROUND: Infectious complications are common in patients implanted with HeartMate 3 (HM3) left ventricular assist devices (LVAD). Despite these issues, some patients with LVAD-specific infection are ultimately considered for heart transplant (HT). The impact of HM3 LVAD-associated infection on postHT outcomes remains unclear. METHODS: We reviewed all adult patients who were listed for HT at Duke University Hospital between 1/1/2014 and 12/31/2024 (n = 1267) and identified 115 patients with a HM3 device who underwent HT. These 115 patients were further stratified based on pre-HT LVAD-specific infection. We assessed the impact of LVAD-specific infection on short-term postHT complications, including length of hospitalization, primary graft dysfunction (PGD), episodes of acute rejection, and occurrences of postHT hospitalization with infection up to 1-year. Kaplan-Meier analysis was used to assess risk of death after HT. RESULTS: Of the 115 patients, 59 patients (51%) had HM3 LVAD-specific infection prior to HT. Compared to patients without pre-HT LVAD-specific infection, there was no difference in 1 year post-HT survival (p = 0.14). Similarly, there was no difference in postHT length of stay (p = 0.435), treated acute rejection (p = 0.536), or severe PGD (p = 0.166). CONCLUSIONS: For carefully selected patients with HM3 LVAD-specific infections, HT appears to be a safe option without excess short-term morbidity or mortality HT.

Duke Scholars

Author Carmelo Alessio Milano Surgery, Cardiovascular and Thoracic Surgery

Author Stuart Dean Russell Medicine, Cardiology

Author Jacob Niall Schroder Surgery, Cardiovascular and Thoracic Surgery

Author Sonya Mansukhlal Kothadia Medicine, Infectious Diseases

Author Adam David DeVore Medicine, Cardiology

Author Joseph Buckley Lerman Medicine, Cardiology

Author Patrick Chung Kay Tam Medicine, Infectious Diseases

Author Madeleine Rose Heldman Medicine, Infectious Diseases

Author Aferdita Spahillari Medicine, Cardiology

Author Jeffrey Keenan Surgery, Cardiovascular and Thoracic Surgery