Management of a chronically infected left ventricular assist device with heart transplantation: Two-step simplified approach

Background: The surgical approach for the treatment of a left ventricular assist device with severe infection may be controversial.

Material & methods: We present the case of a patient implanted with a HeartWare™ HVAD as a bridge to transplant and chronic infection of the device by Pseudomonas who underwent a conservative partial treatment of the driveline tunnel and subsequently a heart transplantation and device removal were done.

Conclusions: The two-step simplified approach allowed the patient to be transplanted in a short period of time, with the abdominal wall healed and almost two-thirds of the driveline subcutaneous tunnel sterilized.