Pump exchange for major device related infection in patients receiving a durable left ventricular assist device.

Background: Device-related infection (DRI) remains a cause of morbidity and mortality following durable left ventricular assist device (dLVAD) implantation. We evaluated outcomes following pump exchange (PE) for DRI following dLVAD implantation.

Methods: Forty-nine patients underwent PE between 1/2007 and 12/2022 for major DRI. Outcomes included survival, incidence of subsequent DRI, and proportion of patients achieving success (freedom from DRI at 1-year following PE).

Results: Median age was 49 years. Median time from primary implant to DRI diagnosis and from diagnosis to PE was 26 and 4.1 months, respectively. Median time to DRI recurrence was 5.8 months with 76% of patients achieving success. Success was obtained in 23/24 (96%) of patients whose time to PE from DRI diagnosis was ≤4 months and 14/25 (56%) if time >4 months.

Conclusion: Most patients achieve success following PE for DRI. The risk of subsequent DRI and mortality remains high. Early (≤4 months) PE following DRI diagnosis increases the likelihood of success, while reducing the rate of subsequent DRI.