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2016 ; 30
(2
): 60-5
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Treatment of Infected Cardiac Implantable Electronic Devices
#MMPMID27152097
Fakhro A
; Jalalabadi F
; Brown RH
; Izaddoost SA
Semin Plast Surg
2016[May]; 30
(2
): 60-5
PMID27152097
show ga
With their rising benefits, cardiac implantable electronic devices (CIEDs) such
as pacemakers and left ventricular assist devices (LVADs) have witnessed a sharp
rise in use over the past 50 years. As indications for use broaden, so too does
their widespread employment with its attendant rise of CIED infections. Such
large numbers of infections have inspired various algorithms mandating treatment.
Early diagnosis of inciting organisms is crucial to tailoring appropriate
antibiotic and or antifungal treatment. In addition, surgical debridement and
explant of the device have been a longstanding modality of care. More novel
therapies focus on salvage of the device by way of serial washouts and instilling
drug-eluting antibiotic impregnated beads into the wound. The wound is then
serially debrided until clean and closed. This technique is better suited to
patients whose device cannot be removed, patients who are poor candidates for
cardiac surgery, or patients who have failed conventional prior treatments.