Language
English
Publication Date
4-1-2026
Journal
Artificial Organs
DOI
10.1111/aor.70082
PMID
41423428
PMCID
PMC13125384
PubMedCentral® Posted Date
12-21-2025
PubMedCentral® Full Text Version
Post-print
Abstract
Background: Left ventricular assist device (LVAD) driveline infections significantly impact patient outcomes. This study aimed to identify their risk factors.
Methods: We analyzed LVAD data from our institutional Intermacs database (January 1, 2008-December 31, 2023), combining primary implants and pump exchanges. Patient characteristics were summarized as frequencies for categorical variables and median (IQR) for continuous variables. The nature of repeated infection events was handled by the Andersen-Gill method within a multivariable Cox proportional hazards model for cause-specific hazard of driveline infections, accounting for death and heart transplant as competing risks.
Results: Our cohort included 1026 LVAD implants. Median patient age was 57.7, and 79.6% were male. Cumulative driveline infection rates at 1, 2, 3, 4, and 5 years were 11.9%, 19.6%, 29.3%, 38.9%, and 40.1%, respectively, with a median time to infection of 13.8 months. Severe diabetes (HbA1c ≥ 8) increased driveline infection risk by 52% (HR = 1.52, p = 0.031). Pulsatile-flow, fully magnetically levitated, and axial-flow LVADs had a 245%, 70%, and 44% higher risk of driveline infections compared to partial magnetically levitated LVADs (HR = 3.45, p = 0.003; HR = 1.70, p = 0.066; HR = 1.44, p = 0.087, respectively). Paradoxically, patients 40 or above had over 58% lower risk of driveline infections than those under 40 (HR < 0.42, p < 0.001). In addition, coronary artery disease was associated with 56% lower risk of driveline infections (HR = 0.44, p = 0.001).
Conclusions: Driveline infections remain prevalent in LVAD patients, especially those with severe diabetes. The lower driveline infection risk in older patients, those with coronary artery disease, and partially magnetically levitated LVADs warrants further investigation.
Keywords
Humans, Heart-Assist Devices, Male, Middle Aged, Female, Prosthesis-Related Infections, Risk Factors, Aged, Longitudinal Studies, Retrospective Studies, Heart Failure, Adult, driveline infections, left ventricular assist device, mechanical circulatory support
Published Open-Access
yes
Recommended Citation
Nguyen, Anh; Shafii, Alexis; Loor, Gabriel; et al., "Driveline Infections Among Patients Supported With Left Ventricular Assist Devices: A Single Center Sixteen-Year Longitudinal Profile" (2026). Faculty, Staff and Students Publications. 6794.
https://digitalcommons.library.tmc.edu/baylor_docs/6794