Abstract 14622: Infections in Patients With a Total Artificial Heart May Be Common but Rarely Fatal
Background: Infectious complications are common in patients with durable left ventricular assist devices. However, data on infections in patients with a total artificial heart (TAH) are limited.
Objective: To describe the incidence, types, and outcomes of infections in patients with a TAH.
Methods: Patients who received a TAH at Virginia Commonwealth University (VCU) between January 1, 2010 and December 31, 2011 were identified from the VCU Mechanical Circulatory Support Clinical Database. Retrospective data extraction from the medical records was performed from the time of TAH implantation until heart transplantation or death. Blood and other appropriate cultures were routinely obtained whenever a suspicion of infection was present. Infections were classified as confirmed (as documented by the patient chart) or suspected (if cultures were negative but antibiotics were administered).
Results: Twenty-seven men and 5 women, mean age 49.5 years (range 24 to 68 years) received a TAH. The mean duration of TAH support was 225 days (range 1 to 1334 days). Of the 32 patients, 4 (12.5%) died prior to transplantation, and 28 (87.5 %) received a heart transplant. Causes of death were pneumonia (n=1), TAH malfunction (n=1), refractory cardiogenic shock (n=1), and respiratory failure (n=1). Thus, only one death was attributed to infection. Seventy documented and 13 suspected infections developed in 25 of the 32 patients (78%). Most common locations of infection were the urinary tract (n=26), the respiratory tract (n=18), and the bloodstream (n=11). There were 5 infections of the pump and 2 drive line infections. The number of infections per patient ranged from 0 to 10. Sixteen different pathogens were identified; the most common were: Klebsiella pneumoniae (n=15), coagulase-negative Staphylococci (n=10), Enterococcus species (n=9) and Enterobacter species (n=8).
Conclusion: In this group of patients undergoing TAH as a bridge to cardiac transplantation, infections were common. However, mortality directly attributable to infection was infrequent.
Author Disclosures: L.F. Hidalgo: None. K.B. Shah: None. R.H. Cooke: None. D.G. Tang: None. V. Kasirajan: None. H.A. Cooper: None. W.S. Aronow: None.
- © 2016 by American Heart Association, Inc.