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Affiliation(s)
- Nowell M. Fine
- Division of Cardiology, Department of Cardiac Sciences and Community Health Sciences, Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Látal J, Špaček M, Přeček J, Tüdös Z, Hutyra M, Tichý T, Táborský M. Giant-cell myocarditis - A case report and a brief review. COR ET VASA 2018. [DOI: 10.1016/j.crvasa.2017.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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3
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Muñoz P, Valerio M, Vásquez V, Velásquez-Rodríguez J, Sousa I, Zatarain E, Barrio JM, Ruiz M, Cuerpo G, Rodríguez-Abella H, Hortal J, Bouza E. Infections in patients after Berlin Heart ® EXCOR assist device implantation. Transpl Infect Dis 2018; 20:e12936. [PMID: 29846991 DOI: 10.1111/tid.12936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Revised: 05/21/2018] [Accepted: 05/23/2018] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Berlin Heart® EXCOR devices (BHED) are ventricular assist devices (VAD) used mainly as a bridge to heart transplantation (HT) in pediatric population. The aim of our study is to report the infections diagnosed in adult patients undergoing a BHED implantation. METHODS Adult patients receiving a BHED between Jul 2009 and Oct 2017 at our institution were included. Infections were classified according to the International Society of Heart and Lung Transplantation definitions in VAD-Specific (VAD-S), VAD-Related (VAD-R) and non-VAD (N-VAD). RESULTS Fifteen patients underwent BHED implantation, which was maintained for a mean of 92 (19-195) days. Infection occurred in 13 patients who developed 36 infectious episodes: 5 VAD-S (5 cannula infections); 8 VAD-R (5 bloodstream infections and 3 mediastinitis) and 24 N-VAD (7 urinary tract infections, 6 Cytomegalovirus diseases and others). Overall, 27 (75%) were bacterial, 7 (19.4%) were viral and there was one (2.7%) fungal infection. Eleven patients underwent HT and all of them developed at least one infection after it. In 3 cases, all VAD-R or VAD-S infections were caused by the same etiology as before HT. Their median time of appearance was on day +6 (3-11) after BHED removal and HT. Overall mortality was 6/15 (40%). None of the deaths were related to VAD Infection. CONCLUSIONS Infection complicated BHED implantation in 86.7% of the patients. Overall, 13.9% were specific of BHED and 22.2% were related. However, infections did not preclude HT in any case and carried no attributable mortality.
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Affiliation(s)
- Patricia Muñoz
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,CIBERES, Madrid, Spain
| | - Maricela Valerio
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain
| | - Víctor Vásquez
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Iago Sousa
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Eduardo Zatarain
- Department of Cardiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - José María Barrio
- Department of Anesthesia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Manuel Ruiz
- Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Gregorio Cuerpo
- Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Hugo Rodríguez-Abella
- Department of Cardiovascular Surgery, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Javier Hortal
- Department of Anesthesia, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Emilio Bouza
- Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Madrid, Spain.,Instituto de Investigación Biomédica Gregorio Marañón, Madrid, Spain.,Department of Medicine, Universidad Complutense de Madrid, Madrid, Spain.,CIBERES, Madrid, Spain
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