Left ventricular assist device temporary explantation as a strategy for infection control in a pediatric patient

Akiko Umetsu; Masaki Taira; Moyu Hasegawa; Takuji Watanabe; Yuji Tominaga; Takayoshi Ueno; Daisuke Yoshioka; Kazuo Shimamura; Shigeru Miyagawa

doi:10.1007/s10047-024-01432-4

Left ventricular assist device temporary explantation as a strategy for infection control in a pediatric patient

J Artif Organs. 2024 Mar 23. doi: 10.1007/s10047-024-01432-4. Online ahead of print.

Authors

Akiko Umetsu¹, Masaki Taira², Moyu Hasegawa¹, Takuji Watanabe¹, Yuji Tominaga¹, Takayoshi Ueno¹, Daisuke Yoshioka¹, Kazuo Shimamura¹, Shigeru Miyagawa¹

Affiliations

¹ Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan.
² Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka, 565-0871, Japan. taira@surg1.med.osaka-u.ac.jp.

PMID: 38520590
DOI: 10.1007/s10047-024-01432-4

Abstract

We report a case of temporary Berlin Heart EXCOR® explantation in a pediatric patient with idiopathic dilated cardiomyopathy who suffered an uncontrollable inflow cannulation site infection while on bridge-to-transplantation. Despite failure to thrive and catheter-related infections, once free of the device, the patient was cured of infection using systemic antibiotics and surgical debridement. The patient underwent EXCOR® reimplantation after four months, and is awaiting heart transplantation in stable condition. A life-threatening ventricular assist device-related infection may require device explantation under conditions that may not fulfill conventional explantation criteria despite risks. Temporary explantation can be an effective strategy if isolated systolic dysfunction is managed carefully.

Keywords: EXCOR; Heart failure; Ventricular assist device; Ventricular assist device explantation; Ventricular assist device infection.