Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall 4EF
Background: The total artificial heart (TAH) has become a reliable bridge to heart transplantation. There are no studies describing the timing of infections post-TAH implantation. Our study sought to assess timing of infections after TAH.
Methods: This is a retrospective study of patients who underwent a TAH implantation at our institution. All continuous variables were reported as medians and respective ranges. All categorical variables were analyzed as proportions.
Results: Nine patients were included in the study with median age of 48 years (21-61 years), BMI of 26.0 (22.3-39.4), and BSA of 2.04 (1.63-2.50). 78% of patients had an infection. The median time from TAH implantation to the first infection was 15 days (5-32 days), and the median time to the last infection was 59 days (36-152 days). The median EF prior to implantation was 15% (0-40%). These patients were at a high risk for infection with pre-TAH diabetes 2/9 (22%), chronic renal failure 5/9 (56%), IABP 3/9 (33%), and ECMO 2/9 (22%). After TAH implantation, patients had a median of 8 days (2-65 days) on ventilator support with a median ICU stay of 44 days (5-65 days).
|Type of Infection||Median Time to Infection (range in days)||Number of Patients||Organisms|
|Surgical Wound||36 days||1||C. albicans|
|Mediastinitis||24 (20-28)||2||S. epidermidis|
|Urinary Tract Infections||19 (5-32)||2||E. faecalis|
|Gastrointestinal Infections||84 (16-152)||2||C. difficile|
|Bloodstream Infections||58 (16-127)||5||MRSA|
E faecalis, C. dubliniensisin same patient
C. albicans x 2 episodes in same patient
S. epidermidis x 2 episodes in same patient
not identified x 3 patients
|HSV Viremia||42 days||1||HSV-1|
|Sinusitis||57 days||1||No organism|
|CMV viremia||21 days||1||CMV|
Four patients experienced 7 episodes of pneumonia. Five patients had 8 episodes of bloodstream infections. The median time from the TAH implantation-to-death was 2 months (0-16 months); the median time-to-transplantation was 3.5 months (2-6 months).
Conclusion: Infections are common in patients who receive a TAH. Most of the infections are due colonizers. Extending perioperative antibiotics would not reduce infection rates but might promote emergence of multidrug resistant organisms.
CITATION INFORMATION: Chambers H., Kalil A., Florescu D. Timing of Infections after Total Artificial Heart Implantation. What Did We Learn? Am J Transplant. 2017;17 (suppl 3).
To cite this abstract in AMA style:Chambers H, Kalil A, Florescu D. Timing of Infections after Total Artificial Heart Implantation. What Did We Learn? [abstract]. https://atcmeetingabstracts.com/abstract/timing-of-infections-after-total-artificial-heart-implantation-what-did-we-learn/. Accessed October 21, 2018.
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