M. Rizwan Sohail;1,4 for the Mayo Cardiovascular Infections Study Group

Background. Infection is a serious complication of left ventricular assist device (LVAD) therapy. Published data regarding LVAD-associated infections (LVADIs) are limited by single-center experiences and use of nonstandar-dized definitions. Methods. We retrospectively reviewed 247 patients who underwent continuous-flow LVAD implantation from January 2005 to December 2011 at Mayo Clinic campuses in Minnesota, Arizona, and Florida. LVADIs were defined using the International Society for Heart and Lung Transplantation criteria. Results. We identified 101 episodes of LVADI in 78 patients (32%) from this cohort. Mean age ( ± standard deviation [SD]) was 57±15 years. The majority (94%) underwent Heartmate II implantation, with 62 % LVADs placed as desti-nation therapy. The most common type of LVADIs were driveline infections (47%), followed by bloodstream infec-tions (24 % VAD related, and 22 % non-VAD related). The most common causative pathogens included gram-positive cocci (45%), predominantly staphylococci, and nosocomial gram-negative bacilli (27%). Almost half (42%) of the patients were managed by chronic suppressive antimicrobial therapy. While 14 % of the patients had intrao-perative debridement, only 3 underwent complete LVAD removal. The average duration (±SD) of LVAD support was 1.5±1.0 years. At year 2 of follow-up, the cumulative incidence of all-cause mortality was estimated to be 43%. Conclusion. Clinical manifestations of LVADI vary on the basis of the type of infection and the causative patho