Ventricular Assist Device-Specific Infections

Ventricular assist devices (VADs) have been shown to offer a significant survival benefit over medical therapy in patients with advanced heart failure. Despite significant advances in device technology and surgical technique, VAD-specific infections still remain among the most common causes of morbidity and mortality in patients with VADs. VAD-specific infections may involve the driveline exit site, the VAD pocket, or the device pump/cannula. The incidence of infection after VAD implantation depends on the type of device implanted, the location of the device, pre-operative patient characteristics, and post-operative driveline/device management. This chapter provides a summary of the various characteristics that may contribute to a patient’s risk of VAD-specific infection and describes pre-, peri-, and postoperative management to aid in limiting the risk of VAD-specific infection. The chapter also includes definitions of the various types of VAD-specific infections and outlines a general guideline for the treatment of these different infections. This guide builds upon current literature available on VAD-specific infection (Chinn et al., 2005; Slaughter et al., 2010).