Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study

Omar Saeed; Noah Moss; Bryan Barrus; Himabindu Vidula; Samit Shah; Scott Feitell; Kristi S. Masser; Arman Kilic; Danyaal Moin; Pavan Atluri; Edo Barati

doi:10.1111/aor.14187

Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study

Omar Saeed, Noah Moss, Bryan Barrus, Himabindu Vidula, Samit Shah, Scott Feitell, Kristi S. Masser, Arman Kilic, Danyaal Moin, Pavan Atluri, Edo Barati

Research output: Contribution to journal › Article › peer-review

4 Scopus citations

Abstract

Purpose: Driveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited studies are available to describe the center-level prevalence, preventive practices, and their potential effectiveness. Methods: We surveyed LVAD centers in the United States to determine program burden and preventive practices for DLI during HeartMate (HM) 3 support. An online, anonymous, question-based survey was sent to expert providers at implanting centers. Only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported prevalence of DLI. Results: Seventy-eight centers responded to the survey (response rate: 50%). Respondents were comprised of 37 (47%) heart failure cardiologists, 27 (35%) LVAD coordinators, and 14 (18%) cardiothoracic surgeons. The prevalence of DLI during HM3 was reported as ≤10% by 27 (35%), 11%–25% by 36 (46%), and >25% by 16 (19%) centers. Thirteen (17%) centers had a body mass index threshold for device placement, 29 (37%) utilized a counter incision, 66 (81%) placed an anchor stitch, and 69 (88%) used an external device to stabilize the DL. Proportionally, more centers with a low DLI prevalence used a wound vacuum 6 (22%) versus 3 (6%, p = 0.03) than those with high DLI. Conclusion: Variation exists in reported prevalence and practices of preventing and managing driveline infections across centers during HM3 support. Further studies are warranted to develop and assess the effectiveness of standardized preventive strategies.

Original language	English (US)
Pages (from-to)	1409-1414
Number of pages	6
Journal	Artificial Organs
Volume	46
Issue number	7
DOIs	https://doi.org/10.1111/aor.14187
State	Published - Jul 2022
Externally published	Yes

Keywords

driveline infection
left ventricular assist device
primary prevention

ASJC Scopus subject areas

Bioengineering
Medicine (miscellaneous)
Biomaterials
Biomedical Engineering

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10.1111/aor.14187

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title = "Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study",

abstract = "Purpose: Driveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited studies are available to describe the center-level prevalence, preventive practices, and their potential effectiveness. Methods: We surveyed LVAD centers in the United States to determine program burden and preventive practices for DLI during HeartMate (HM) 3 support. An online, anonymous, question-based survey was sent to expert providers at implanting centers. Only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported prevalence of DLI. Results: Seventy-eight centers responded to the survey (response rate: 50%). Respondents were comprised of 37 (47%) heart failure cardiologists, 27 (35%) LVAD coordinators, and 14 (18%) cardiothoracic surgeons. The prevalence of DLI during HM3 was reported as ≤10% by 27 (35%), 11%–25% by 36 (46%), and >25% by 16 (19%) centers. Thirteen (17%) centers had a body mass index threshold for device placement, 29 (37%) utilized a counter incision, 66 (81%) placed an anchor stitch, and 69 (88%) used an external device to stabilize the DL. Proportionally, more centers with a low DLI prevalence used a wound vacuum 6 (22%) versus 3 (6%, p = 0.03) than those with high DLI. Conclusion: Variation exists in reported prevalence and practices of preventing and managing driveline infections across centers during HM3 support. Further studies are warranted to develop and assess the effectiveness of standardized preventive strategies.",

keywords = "driveline infection, left ventricular assist device, primary prevention",

author = "Omar Saeed and Noah Moss and Bryan Barrus and Himabindu Vidula and Samit Shah and Scott Feitell and Masser, {Kristi S.} and Arman Kilic and Danyaal Moin and Pavan Atluri and Edo Barati",

note = "Publisher Copyright: {\textcopyright} 2022 International Center for Artificial Organs and Transplantation and Wiley Periodicals LLC.",

year = "2022",

month = jul,

doi = "10.1111/aor.14187",

language = "English (US)",

volume = "46",

pages = "1409--1414",

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TY - JOUR

T1 - Preventing driveline infection during left ventricular assist device support by the HeartMate 3

T2 - A survey-based study

AU - Saeed, Omar

AU - Moss, Noah

AU - Barrus, Bryan

AU - Vidula, Himabindu

AU - Shah, Samit

AU - Feitell, Scott

AU - Masser, Kristi S.

AU - Kilic, Arman

AU - Moin, Danyaal

AU - Atluri, Pavan

AU - Barati, Edo

PY - 2022/7

Y1 - 2022/7

N2 - Purpose: Driveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited studies are available to describe the center-level prevalence, preventive practices, and their potential effectiveness. Methods: We surveyed LVAD centers in the United States to determine program burden and preventive practices for DLI during HeartMate (HM) 3 support. An online, anonymous, question-based survey was sent to expert providers at implanting centers. Only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported prevalence of DLI. Results: Seventy-eight centers responded to the survey (response rate: 50%). Respondents were comprised of 37 (47%) heart failure cardiologists, 27 (35%) LVAD coordinators, and 14 (18%) cardiothoracic surgeons. The prevalence of DLI during HM3 was reported as ≤10% by 27 (35%), 11%–25% by 36 (46%), and >25% by 16 (19%) centers. Thirteen (17%) centers had a body mass index threshold for device placement, 29 (37%) utilized a counter incision, 66 (81%) placed an anchor stitch, and 69 (88%) used an external device to stabilize the DL. Proportionally, more centers with a low DLI prevalence used a wound vacuum 6 (22%) versus 3 (6%, p = 0.03) than those with high DLI. Conclusion: Variation exists in reported prevalence and practices of preventing and managing driveline infections across centers during HM3 support. Further studies are warranted to develop and assess the effectiveness of standardized preventive strategies.

AB - Purpose: Driveline infection (DLI) is a significant source of morbidity and mortality during left ventricular assist device (LVAD) support yet limited studies are available to describe the center-level prevalence, preventive practices, and their potential effectiveness. Methods: We surveyed LVAD centers in the United States to determine program burden and preventive practices for DLI during HeartMate (HM) 3 support. An online, anonymous, question-based survey was sent to expert providers at implanting centers. Only a single respondent completed the survey for each center. As an exploratory analysis, we compared specific DLI preventive practices between centers with low (≤10%) and high (>10%) reported prevalence of DLI. Results: Seventy-eight centers responded to the survey (response rate: 50%). Respondents were comprised of 37 (47%) heart failure cardiologists, 27 (35%) LVAD coordinators, and 14 (18%) cardiothoracic surgeons. The prevalence of DLI during HM3 was reported as ≤10% by 27 (35%), 11%–25% by 36 (46%), and >25% by 16 (19%) centers. Thirteen (17%) centers had a body mass index threshold for device placement, 29 (37%) utilized a counter incision, 66 (81%) placed an anchor stitch, and 69 (88%) used an external device to stabilize the DL. Proportionally, more centers with a low DLI prevalence used a wound vacuum 6 (22%) versus 3 (6%, p = 0.03) than those with high DLI. Conclusion: Variation exists in reported prevalence and practices of preventing and managing driveline infections across centers during HM3 support. Further studies are warranted to develop and assess the effectiveness of standardized preventive strategies.

KW - driveline infection

KW - left ventricular assist device

KW - primary prevention

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Preventing driveline infection during left ventricular assist device support by the HeartMate 3: A survey-based study

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Keywords

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