Abstract 3131: Axial Flow LVADs are Associated with Fewer Device-Related Infections than Pulsatile LVADs
Objective: Infection is one of the most common sources of morbidity and mortality during mechanical circulatory support. The purpose of this study was to determine if axial flow left ventricular assist devices (LVADs) are more or less prone to infection than pulsatile LVADs.
Methods: We retrospectively reviewed medical records from 100 consecutive patients undergoing LVAD-implant at our center between 2003 and 2006. LVADs were classified as either pulsatile (n = 74) or axial flow (n = 26). Local device infection was defined by clinical signs of infection with positive culture(s) from the abdominal wound, driveline, pocket, or pump. Kaplan-Meier survival distribution, chi-square test, and logistic regression were used to analyze the association between device type and device infection.
Results: There was no significant difference between the axial flow and pulsatile device groups with respect to age, gender, ethnicity, or preoperative history of diabetes. Patients receiving a pulsatile device were more likely to develop an LVAD-related infection (24.7 vs. 3.7%, p < .05). This difference was most striking with respect to pocket-related infections (9.1% vs. 0%, p=.105) and driveline infections (11.7% vs. 3.7%, p=.22). Of note, the rate of post-implant bacteremia was comparable between groups (23.4% vs. 25.9%, p=NS). There was a trend towards a higher incidence of post-implant sepsis (13.0% vs. 3.7%, p=0.18) and longer ICU length of stay (49 +/− 59 days vs. 35.0 +/− 21 days, p=.075) in the pulsatile group. Device infections had no effect on bridge-to-transplant rate or post-VAD survival in either group