Haddad Osama, Pham Anthony N, Thomas Mathew, Ali Mojahid, Sareyyupoglu Basar, El-Sayed Ahmed Magdy M, Pham Si M
Department of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida.
J Card Surg. 2020 Aug;35(8):2073-2076. doi: 10.1111/jocs.14778. Epub 2020 Jul 11.
Ventricular assist devices driveline infections are common, recalcitrant, and carry high morbidity and mortality. Herein, we reported a patient with driveline infection that was successfully treated with a combination of systemic antibiotics, surgical debridement, and instillation of absorbable antibiotic beads to the wound bed.
A 39-year-old man with nonischemic cardiomyopathy underwent insertion of a continuous flow left ventricular assist device. Four years postoperatively, the patient presented with clinical, laboratory, and radiologic signs of driveline tract infection. He underwent extensive surgical debridement, installation of absorbable antibiotic beads that consisted of calcium sulfate, vancomycin, and tobramycin, into the wound bed, and systemic antibiotics. The patient was free of infection 9 month postoperatively.
Absorbable calcium sulfate antibiotic beads may serve as a beneficial adjunct to surgical debridement and systemic antibiotics for the treatment of ventricular assist device driveline infection, and merit further investigation.
心室辅助装置的驱动线感染很常见，难以治愈，且具有高发病率和死亡率。在此，我们报告了一名驱动线感染患者，通过全身抗生素、手术清创以及在伤口床植入可吸收抗生素珠的联合治疗而成功治愈。
一名39岁的非缺血性心肌病男性患者接受了连续血流左心室辅助装置植入术。术后四年，患者出现了驱动线感染的临床、实验室及影像学表现。他接受了广泛的手术清创，在伤口床植入了由硫酸钙、万古霉素和妥布霉素组成的可吸收抗生素珠，并使用了全身抗生素。术后9个月患者无感染。
可吸收硫酸钙抗生素珠可作为手术清创和全身抗生素治疗心室辅助装置驱动线感染的有益辅助手段，值得进一步研究。
Zotero 插件