Therapy of cardiac device pocket infections with vacuum-assisted wound closure-long-term follow-up

Abstract

Background: Cardiac device infections are serious complications that require aggressive treatment strategies, including interventional or surgical lead extraction.

Methods: Here we describe the long-time follow-up of vacuum-assisted closure (V.A.C.) treatment in five patients with local cardiac device infection (LDI). In these patients the device was removed, the electrodes were shortened, and a V.A.C. treatment was applied. The primary endpoint was defined as time to re-LDI.

Results: Three patients had LDI of a pacemaker pocket, whereas two presented with an infection of their ICD pocket. The V.A.C. treatment was applied for 34.4 ± 17.9 days. The mean hospitalization time was 38.6 ± 19.2 days. The follow-up period was assessed for 34.6 ± 19.2 months. Only one patient developed re-LDI, 69 days after removal of the device. The other four patients did not show any signs of reinfection during the follow-up period. None of the five patients sustained serious adverse events.

Conclusions: V.A.C. treatment may be an option for selected patients with LDI who refuse a laser-guided lead extraction or surgical removal of the electrodes as the primary therapy.