McCarthy P M, Schmitt S K, Vargo R L, Gordon S, Keys T F, Hobbs R E
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195, USA.
Ann Thorac Surg. 1996 Jan;61(1):359-65; discussion 372-3. doi: 10.1016/0003-4975(95)00990-6.
Infection in implantable left ventricular assist device (LVAD) patients is common and has serious implications regarding permanent use of the LVAD.
Thirty-three patients had HeartMate LVAD insertion as a bridge to heart transplantation. The mean length of hospital stay was 8 days before LVAD insertion. Before insertion 6 patients (18%) had positive pulmonary cultures and 5 patients (15%) had bacteremia.
During LVAD support 18 patients (55%) had bloodstream infection. Of 24 patients (73%) successfully bridged to transplantation, 12 (50%) had positive blood cultures including Staphylococcus species (n = 9), Candida (n = 3), Pseudomonas (n = 2), and Enterococcus (n = 2). Infectious complications encountered in this series included driveline infection requiring surgical revision, septic embolus, "cleared" device infection, "suppressed" device infection, and LVAD infection treated by device removal in 1 patient and device exchange in another.
Infection in implantable LVAD patients is common, especially in patients in whom multiple organ failure develops, requiring prolonged stay in the intensive care unit. Strategies are needed to prevent these infections in recipients of the permanent LVADs because treatment of an established infection is difficult and expensive.
植入式左心室辅助装置（LVAD）患者发生感染很常见，且对LVAD的长期使用有严重影响。
33例患者植入HeartMate LVAD作为心脏移植的过渡。LVAD植入前平均住院时间为8天。植入前，6例患者（18%）痰培养阳性，5例患者（15%）发生菌血症。
在LVAD支持期间，18例患者（55%）发生血流感染。在24例成功过渡到移植的患者（73%）中，12例（50%）血培养阳性，包括葡萄球菌属（n = 9）、念珠菌（n = 3）、铜绿假单胞菌（n = 2）和肠球菌（n = 2）。本系列中遇到的感染并发症包括需要手术翻修的驱动线感染、脓毒性栓子、“清除”的装置感染、“抑制”的装置感染，以及1例患者因LVAD感染而移除装置，另1例患者进行装置更换。
植入LVAD的患者感染很常见，尤其是发生多器官功能衰竭且需要在重症监护病房长期住院的患者。由于已发生的感染治疗困难且费用高昂，因此需要采取策略预防永久性LVAD接受者发生这些感染。
