{
    "abstract": "Left ventricular assist devices (LVADs) are implanted in patients with heart failure to support cardiac circulation. However, no standardized methods have been established for LVAD driveline exit site management for the prevention of infections. Therefore, this study evaluated the efficacy of modified driveline management compared with that of conventional driveline management. We retrospectively assessed the outcomes of 262 patients who underwent continuous-flow LVAD implantation between January 2005 and March 2023 at Osaka University in Japan. In conventional driveline management, an LVAD driveline penetrates the skin along the body surface and is fixed near the penetration site (n\u2009=\u2009224). In contrast, in our modified fixation method, the LVAD driveline vertically penetrates the skin to prevent ischemia at the driveline exit site and is fixed at a distant abdominal site to prevent the movement of the driveline exit site due to body movement (n\u2009=\u200938). The rates of freedom from LVAD driveline infection in patients with conventional driveline management were 86, 75, and 63% at 1, 2, and 3\u00a0years after LVAD implantation, respectively. The rate of freedom from LVAD driveline infection in patients managed by the modified fixation method was 91% at 1, 2, as well as 3\u00a0years after LVAD implantation. The freedom rates from LVAD driveline infection in the patients with modified fixation method was lower than in the patients with the conventional method (p\u2009=\u20090.04). Our study revealed that the modified fixation method may offer the possibility for preventing LVAD driveline infection.",
    "authors": [
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan. s-imaoka@surg1.med.osaka-u.ac.jp.",
            "firstname": "Shusuke",
            "initials": "S",
            "lastname": "Imaoka"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Fukui Cardiovascular Hospital, Fukui, Japan.",
            "firstname": "Noriyuki",
            "initials": "N",
            "lastname": "Kashiyama"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan. djason55@gmail.com.",
            "firstname": "Daisuke",
            "initials": "D",
            "lastname": "Yoshioka"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Shunsuke",
            "initials": "S",
            "lastname": "Saito"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Takuji",
            "initials": "T",
            "lastname": "Kawamura"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Ai",
            "initials": "A",
            "lastname": "Kawamura"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Ryohei",
            "initials": "R",
            "lastname": "Matsuura"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Yusuke",
            "initials": "Y",
            "lastname": "Misumi"
        },
        {
            "affiliation": "Department of thoracic and cardiovascular surgery, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.",
            "firstname": "Koichi",
            "initials": "K",
            "lastname": "Toda"
        },
        {
            "affiliation": "Departments of Cardiovascular Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita Shi, Osaka, Osaka fu, 565-0871, Japan.",
            "firstname": "Shigeru",
            "initials": "S",
            "lastname": "Miyagawa"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2024. The Author(s).",
    "doi": "10.1007/s10047-024-01482-8\n10.1016/j.healun.2012.05.004\n10.1016/j.healun.2014.05.010\n10.1097/MAT.0b013e3181c879b1\n10.1097/MAT.0000000000000916\n10.21037/jtd.2020.03.26\n10.1001/jama.2022.16197\n10.1016/j.healun.2017.06.007\n10.3390/healthcare3030750\n10.1097/MAT.0000000000002031\n10.1016/j.athoracsur.2007.03.085\n10.1093/icvts/ivt549\n10.1097/MAT.0000000000000374\n10.1111/aor.14440\n10.1016/j.healun.2011.01.717\n10.1016/j.jtcvs.2010.07.016",
    "journal": "Journal of artificial organs : the official journal of the Japanese Society for Artificial Organs",
    "keywords": [
        "Drive line infection",
        "Left ventricular assist device",
        "Left ventricular assist device drive line"
    ],
    "methods": null,
    "publication_date": "2024-12-19",
    "pubmed_id": "39694982\n22766022\n25087103\n20051832\n30398982\n32642173\n36074476\n28781010\n27417794\n37549664\n17643627\n24431003\n27111738\n36300650\n21419995\n20709333",
    "results": null,
    "title": "Clinical outcomes of modified left ventricular assist device driveline management.",
    "xml": "<Element 'PubmedArticle' at 0x78850607a930>"
}