HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Siegenthaler, M.P. Articles by Beyersdorf, F. Search for Related Content PubMed PubMed Citation Articles by Siegenthaler, M.P. Articles by Beyersdorf, F. Related Collections Cardiac - other Congestive Heart Failure Mechanical Circulatory Assistance

Eur J Cardiothorac Surg 2003;23:748-755
© 2003 Elsevier Science NL

The Jarvik 2000 is associated with less infections than the HeartMate left ventricular assist device¹

Department of Cardiovascular Surgery, Albert-Ludwigs University Freiburg, Hugstetterstrasse 55, 79106 Freiburg, Germany

Received 26 September 2002; received in revised form 22 January 2003; accepted 23 January 2003.

^* Corresponding author. Tel.: +49-761-270-6138; fax: +49-761-270-2550
e-mail: siegenth{at}ch11.ukl.uni-freiburg.de

Objectives: Device-related infections remain a considerable problem of left-ventricular support. We compared the device-related-infections between the HeartMate left ventricular assist device (LVAD) and the Jarvik 2000 permanent LVAD, a device with a novel retroauricular power-supply. Methods: Between December 2000 and September 2002 we implanted the HeartMate-vented, electrical-system in 11 patients and the permanent Jarvik 2000 in six patients. Total support time was 1626 patient-days (HeartMate, 26–271 days) versus 1246 patient-days (Jarvik 2000, 8–411 days). As potential risk factors for infection we analyzed age, preoperative hospital-days, total protein, cardiac index, maximal oxygen uptake, use of inotropes, LVAD risk-score-index and Aaronson-Mancini-score, intubation time, and intensive care unit stay. We used the Center of Disease Control definitions for surgical site infections. Results: HeartMate-patients were younger than Jarvik 2000 patients (46±13 versus 58±6 years, P=0.056), there were no other differences in the risk factors. Four HeartMate-patients needed late (48 h) surgical revisions for bleeding/hematomas versus no revisions in the Jarvik 2000 patients. In the HeartMate-patients, there were seven (64%) driveline-infections, five (45%) device-pocket infections, and three (27%) bloodstream-infections, or 0.43 device-related infections/100 patient-days. Infections occurred early (34±31 days). Three patients required urgent transplantation due to bloodstream infection. There were no adverse outcomes in the HeartMate-group due to infection. In the Jarvik 2000 patients, there was one driveline-infection (16%) after 270 days of support (0.08 device-related infections/100 patient-days), significantly less than in the HeartMate-group (P=0.044). Driveline infections resolved with antibiotics and local wound care in the Jarvik 2000 patient, but only in one of seven HeartMate-patients. Conclusions: Implantation of the Jarvik 2000 is associated with less device-related infections than the HeartMate-LVAD. The power-supply of the permanent Jarvik 2000 is suitable for long-term mechanical support.

Key Words: Heart failure • Left ventricular assist device • TCI Heartmate • Jarvik 2000 • Infection

This article has been cited by other articles:

				S. R. Wilson, M. M. Givertz, G. C. Stewart, and G. H. Mudge Jr Ventricular assist devices the challenges of outpatient management. J. Am. Coll. Cardiol., October 27, 2009; 54(18): 1647 - 1659. [Abstract] [Full Text] [PDF]

				S. Osaki, N. M. Edwards, M. Velez, M. R. Johnson, M. A. Murray, J. A. Hoffmann, and T. Kohmoto Improved survival in patients with ventricular assist device therapy: the University of Wisconsin experience. Eur. J. Cardiothorac. Surg., August 1, 2008; 34(2): 281 - 288. [Abstract] [Full Text] [PDF]

				R. F. Padera Jr. and F. J. Schoen Pathology of Cardiac Surgery Card. Surg. Adult, January 1, 2008; 3(2008): 111 - 178. [Full Text]

				A. Zierer, S. J. Melby, R. K. Voeller, T. J. Guthrie, G. A. Ewald, K. Shelton, M. K. Pasque, M. R. Moon, R. J. Damiano Jr, and N. Moazami Late-Onset Driveline Infections: The Achilles' Heel of Prolonged Left Ventricular Assist Device Support Ann. Thorac. Surg., August 1, 2007; 84(2): 515 - 520. [Abstract] [Full Text] [PDF]

				P. Hendry Invited commentary Ann. Thorac. Surg., August 1, 2007; 84(2): 520 - 521. [Full Text] [PDF]

				S. Haj-Yahia, E. J. Birks, P. Rogers, C. Bowles, M. Hipkins, R. George, M. Amrani, M. Petrou, J. Pepper, G. Dreyfus, et al. Midterm experience with the Jarvik 2000 axial flow left ventricular assist device J. Thorac. Cardiovasc. Surg., July 1, 2007; 134(1): 199 - 203. [Abstract] [Full Text] [PDF]

				M. P. Siegenthaler, J. Martin, R. Gutwald, R. Bahr, S. Westaby, R. Schmelzeisen, and F. Beyersdorf Anterior Approach to Implant the Jarvik 2000 With Retroauricular Power Supply Ann. Thorac. Surg., August 1, 2005; 80(2): 745 - 747. [Abstract] [Full Text] [PDF]

				M. P. Siegenthaler, S. Westaby, O.H. Frazier, J. Martin, A. Banning, D. Robson, J. Pepper, P. Poole-Wilson, and F. Beyersdorf Advanced heart failure: feasibility study of long-term continuous axial flow pump support Eur. Heart J., May 2, 2005; 26(10): 1031 - 1038. [Abstract] [Full Text] [PDF]