Driveline exit site
Tue, 04/04/2023 - 7:59PMI got my LVAD 6 months ago. I have had to overcome many obstacles but now I am happy emotionally and physically. My only concern at the moment is my driveline exit. It's worse than it was 6 months ago, particularly the red shading next to the exit point. My caregiver does an excellent dressing change every day without exception. But it doesn't seem to be healing. Should I be concerned about this? What are my options?
Driveline Exit Site
Mon, 04/10/2023 - 6:09PMMike,
I don’t see anyone else’s reply, but surely others have suggested that you do seek medical assistance immediately. If you haven’t already, I want to encourage you to do the same. It’s extremely important!
Driveline Exit Site
Mon, 04/10/2023 - 6:10PMPam J.
Driveline Exit Site
Mon, 04/10/2023 - 6:09PM
Mike,
I don’t see anyone else’s reply, but surely others have suggested that you do seek medical assistance immediately. If you haven’t already, I want to encourage you to do the same. It’s extremely important!
In reply to Driveline Exit Site by Pam J.
Jarvis J.When in doubt, ALWAYS…
Mon, 04/17/2023 - 9:47PMWhen in doubt, ALWAYS consult your LVAD team.
Root canal
Wed, 04/19/2023 - 10:28AMI was wondering if anybody with LVAD has gone through dental work root canal? Or tooth extraction .
jyotsna
In reply to Root canal by Jyostna P.
Diane B.Dental Work
Mon, 04/24/2023 - 8:12PMDiscuss With LVAD team. Must take antibiotics and have INR in lower end of range which is discussed between the dentist and LVAD team. My husband has had multiple extractions in last year without a problem.
Tooth Extraction
Mon, 04/24/2023 - 2:44PMI unfortunately have had 2 teeth removed. Both times I was advised by my LVAD team to only take antibiotics. Please check with your LVAD team for guidance.
My husband (who has the LVAD…
Tue, 04/25/2023 - 10:05AMMy husband (who has the LVAD) had a molar extraction a couple of months ago. He had slight bleeding all day, but by bedtime it had slowed down a lot. Doctors did not adjust his warfarin dosage at all. Put him on amoxicillin prior to extraction and afterwards. Overall, he did pretty well. I should also say, in that same area of his mouth a prep was done for a future implant.
Driveline Exit Site
Tue, 05/09/2023 - 10:10PMHello Mike,
I did some research on driveline infections for a relative and want to share it with you.
Driveline infections need urgent care because they’re challenging to manage and eradicate. What happens is bacteria colonize the skin to form biofilms. These biofilms attach to the driveline and can migrate up the driveline.
Untreated driveline infections can lead to bloodstream infections, decrease your survival rate while you wait for transplantation, and can infect deeper tissue, the pump pocket, or the pump.
Your doctor will perform an initial work-up which includes a local wound culture, a blood culture, and a chest-abdomen-pelvis image with contrast (CT Image).
Superficial infections require oral or intravenous antibiotics. Deep infections require longer antibiotic therapies, usually 6-8 weeks. Rifampin is commonly used to treat biofilm infections. Rifampin metabolizes Warfarin; the Warfarin dose must be adjusted.
The deepest infections require surgical intervention. If the condition isn't controlled, Incision and drainage are followed by vacuum-assisted closure, omental wrapping, and antibiotic-impregnated beads installed near the infection site. Device replacement is high risk and is done as a last resort. Infection that is unmanageable may require heart transplantation.
Get some answers to your questions. Here’s a starter list:
What are the bacteria that were detected at the wound site? Are the bacteria in my blood? Will you order a CT scan to rule out ascending infection along the driveline? What antibiotics will you prescribe? For what duration? If the infection isn’t controlled, what are the next steps?
Mike, here’s the hyperlink to the blog post with this information: https://criticalcarenow.com/lvad-infections-101/. I wish you the best, and I’d love to read your follow-up post telling us your infection was treated and cured. Keep us informed!
Beth