Successful management of apical abscess after Nipro left ventricular assisted device explantation by removal of apical cuff and omentopexy

J Artif Organs. 2016 Dec;19(4):396-398. doi: 10.1007/s10047-016-0924-7. Epub 2016 Aug 9.

Abstract

Nipro-Toyobo-paracorporeal pulsatile flow VAD (Nipro VAD; Nipro, Osaka, Japan) has been used most commonly as a paracorporeal VAD (p-VAD) in Japan. There are few reports describing clinical course of post LVAD explantation and its complication. We herein present two cases of apical abscess after the explantation of the device. SSI is a main risk factor of formation of the apical abscess at the time of LVAD explantation. It is mandatory to perform sufficient debridement and closure of the layers including abdominal muscle and anterior abdominal fascia at exit sites in the explantation surgery. Omentopexy is also helpful for prevention from infection. Routine removal of apical cuff and outflow graft could be considered as one of the options when LVAD is explanted as bridge to recovery.

Keywords: Apical abscess; LVAD explantation; Nipro VAD; Surgical site infection.

Publication types

  • Case Reports

MeSH terms

  • Abscess / etiology*
  • Abscess / surgery
  • Adult
  • Device Removal*
  • Heart Failure / surgery
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Omentum / surgery
  • Risk Factors
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / surgery