Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis

Tyler M. Bauer; Jae Hwan Choi; Jessica G.Y. Luc; Matthew P. Weber; Ester Moncho Escrivá; Sinal Patel; Elizabeth J. Maynes; Andrew J. Boyle; Louis E. Samuels; John W. Entwistle; Rohinton J. Morris; H. Todd Massey; Vakhtang Tchantchaleishvili

doi:10.1111/aor.13378

Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis

Tyler M. Bauer, Jae Hwan Choi, Jessica G.Y. Luc, Matthew P. Weber, Ester Moncho Escrivá, Sinal Patel, Elizabeth J. Maynes, Andrew J. Boyle, Louis E. Samuels, John W. Entwistle, Rohinton J. Morris, H. Todd Massey, Vakhtang Tchantchaleishvili^*

^*Corresponding author for this work

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

24 Scopus citations

Abstract

No standardized treatment algorithm exists for the management of continuous-flow left ventricular assist device (CF-LVAD)-specific infections. The aim of this systematic review and meta-analysis was to compare the outcomes of CF-LVAD-specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF-LVAD-specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF-LVAD-specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF-LVAD exchange, and 140/158 (88.6%) patients were treated with non-exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow-up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3–50.6) vs. non-exchange 23.3% (15.8–32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7–58.0) vs. non-exchange 38.6% (15.4–68.5), P = 0.56]. In the setting of CF-LVAD-specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non-exchange modalities.

Original language	English
Pages (from-to)	448-457
Number of pages	10
Journal	Artificial Organs
Volume	43
Issue number	5
DOIs	https://doi.org/10.1111/aor.13378
State	Published - May 2019
Externally published	Yes

Keywords

HeartMate II
continuous-flow left ventricular devices
device-specific infections
pump exchange

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10.1111/aor.13378

Cite this

Bauer, T. M., Choi, J. H., Luc, J. G. Y., Weber, M. P., Moncho Escrivá, E., Patel, S., Maynes, E. J., Boyle, A. J., Samuels, L. E., Entwistle, J. W., Morris, R. J., Massey, H. T., & Tchantchaleishvili, V. (2019). Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis. Artificial Organs, 43(5), 448-457. https://doi.org/10.1111/aor.13378

@article{af52cb87e06d4338999a0a94d57d0433,

title = "Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis",

abstract = "No standardized treatment algorithm exists for the management of continuous-flow left ventricular assist device (CF-LVAD)-specific infections. The aim of this systematic review and meta-analysis was to compare the outcomes of CF-LVAD-specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF-LVAD-specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF-LVAD-specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF-LVAD exchange, and 140/158 (88.6%) patients were treated with non-exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow-up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3–50.6) vs. non-exchange 23.3% (15.8–32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7–58.0) vs. non-exchange 38.6% (15.4–68.5), P = 0.56]. In the setting of CF-LVAD-specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non-exchange modalities.",

keywords = "HeartMate II, continuous-flow left ventricular devices, device-specific infections, pump exchange",

author = "Bauer, {Tyler M.} and Choi, {Jae Hwan} and Luc, {Jessica G.Y.} and Weber, {Matthew P.} and {Moncho Escriv{\'a}}, Ester and Sinal Patel and Maynes, {Elizabeth J.} and Boyle, {Andrew J.} and Samuels, {Louis E.} and Entwistle, {John W.} and Morris, {Rohinton J.} and Massey, {H. Todd} and Vakhtang Tchantchaleishvili",

note = "Publisher Copyright: {\textcopyright} 2018 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.",

year = "2019",

month = may,

doi = "10.1111/aor.13378",

language = "English",

volume = "43",

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Bauer, TM, Choi, JH, Luc, JGY, Weber, MP, Moncho Escrivá, E, Patel, S, Maynes, EJ, Boyle, AJ, Samuels, LE, Entwistle, JW, Morris, RJ, Massey, HT & Tchantchaleishvili, V 2019, 'Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis', Artificial Organs, vol. 43, no. 5, pp. 448-457. https://doi.org/10.1111/aor.13378

TY - JOUR

T1 - Device exchange versus nonexchange modalities in left ventricular assist device-specific infections

T2 - A systematic review and meta-analysis

AU - Bauer, Tyler M.

AU - Choi, Jae Hwan

AU - Luc, Jessica G.Y.

AU - Weber, Matthew P.

AU - Moncho Escrivá, Ester

AU - Patel, Sinal

AU - Maynes, Elizabeth J.

AU - Boyle, Andrew J.

AU - Samuels, Louis E.

AU - Entwistle, John W.

AU - Morris, Rohinton J.

AU - Massey, H. Todd

AU - Tchantchaleishvili, Vakhtang

PY - 2019/5

Y1 - 2019/5

N2 - No standardized treatment algorithm exists for the management of continuous-flow left ventricular assist device (CF-LVAD)-specific infections. The aim of this systematic review and meta-analysis was to compare the outcomes of CF-LVAD-specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF-LVAD-specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF-LVAD-specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF-LVAD exchange, and 140/158 (88.6%) patients were treated with non-exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow-up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3–50.6) vs. non-exchange 23.3% (15.8–32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7–58.0) vs. non-exchange 38.6% (15.4–68.5), P = 0.56]. In the setting of CF-LVAD-specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non-exchange modalities.

AB - No standardized treatment algorithm exists for the management of continuous-flow left ventricular assist device (CF-LVAD)-specific infections. The aim of this systematic review and meta-analysis was to compare the outcomes of CF-LVAD-specific infections as managed by device exchange to other treatment modalities not involving device exchange. Electronic search was performed to identify all studies in the English literature relating to the management of CF-LVAD-specific infections. All identified articles were systematically assessed for selection criteria. Thirteen studies with 158 cases of CF-LVAD-specific infection were pooled for analysis. Overall, 18/158 (11.4%) patients underwent CF-LVAD exchange, and 140/158 (88.6%) patients were treated with non-exchange modalities. The proportion of patients with isolated driveline infections or pump or pocket infections did not differ significantly between the groups. During a mean follow-up of 290 days, there were no significant differences in the overall mortality [exchange 17.6% (4.3–50.6) vs. non-exchange 23.3% (15.8–32.9), P = 0.67] and infection recurrence rates [exchange 26.7% (8.7–58.0) vs. non-exchange 38.6% (15.4–68.5), P = 0.56]. In the setting of CF-LVAD-specific infections, device exchange does not appear to confer an advantage in the overall mortality and infection recurrence as compared to non-exchange modalities.

KW - HeartMate II

KW - continuous-flow left ventricular devices

KW - device-specific infections

KW - pump exchange

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U2 - 10.1111/aor.13378

DO - 10.1111/aor.13378

M3 - Article

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AN - SCOPUS:85057115641

SN - 0160-564X

VL - 43

SP - 448

EP - 457

JO - Artificial Organs

JF - Artificial Organs

IS - 5

ER -

Device exchange versus nonexchange modalities in left ventricular assist device-specific infections: A systematic review and meta-analysis

Abstract

Keywords

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