DRIVELINE INFECTION IN TWO CONTEMPORARY LEFT VENTRICULAR ASSIST DEVICES: A SINGLE CENTER RETROSPECTIVE ANALYSIS

Background and Aim: Driveline infection (DLI) are common adverse events in left ventricular assist devices (LVADs) leading to severe complications and re-admissions. Methods: The study aims to characterize risk factors for DLI at 6 months postimplant. This single-center analysis included 137 LVAD consecutive patients (n=76 HeartMate3 [HM3], n=61 HeartWare [HVAD]; male 84.7%, mean age 59.4±8.7) implanted between 2010 and 2024. Demographics, clinical parameters, surgical strategies and outcomes were retrospectively analyzed. Results: At 6 months of LVAD support, 6.6% of patients were readmitted for DLI, 19% experienced DLI but were treated in the outpatient setting, and 74.4% had no DLI. Among DLI patients cohort at 6 months, the analysis showed an increased rate of pre-operative bloodstream infection (mostly Gram+ Cocci; 15.6% vs. 6.7% of no-DLI cohort, respectively, p=0.003), diabetes (28.1% vs. 20.2%, p=0.038), high BMI (25.8 vs. 23.8, p=0.05) and previous cardiac surgery (18.8 vs 11.5%, p=0.045). DLI occurred more frequently in the case of ‘-shape driveline tunnelling’ technique. HM3 patients showed less rate of DLI if ‘direct driveline tunnelling’ technique was adopted. Conclusions: DLI remains a delicate issue to address in LVAD recipients. Pre-operative risk factors should be properly weighted. ‘Direct tunnelling’ technique for driveline placement may represent a protective factor.