[Reconstructive surgery in patients with a ventricular assist device (VAD)--an interdisciplinary challenge]

Handchir Mikrochir Plast Chir. 2012 Apr;44(2):97-102. doi: 10.1055/s-0031-1279763. Epub 2011 Jul 13.
[Article in German]

Abstract

Background: Ventricular assist devices (VAD) are implanted with a growing frequency in patients with end-stage heart failure. In spite of technical and therapeutic advances, there is still a high incidence of device infections and healing disturbances with a considerable mortality. Reconstructive plastic surgery is able to provide help in erradicating infections and covering defects.

Patients and methods: 11 patients with device infections and soft tissue defects were treated in our institution. All cases were treated with local myocutaneous or muscle flaps.

Results: Three patients had postoperative haematomas which had to be revised surgically. One patient had a persistent fistula of mediastinal origin but without clinical symptoms of infection. One patient exhibited an enterocutaneous fistula after defect coverage.

Conclusion: Patients with VADs have a high possibility of perioperative complications. Therefore a close interdisciplinary approach with plastic and cardiovascular surgeons is absolutely essential.

Publication types

  • English Abstract

MeSH terms

  • Adult
  • Aged
  • Comorbidity
  • Cooperative Behavior*
  • Female
  • Fistula / surgery
  • Follow-Up Studies
  • Heart Failure / surgery*
  • Heart Transplantation
  • Heart-Assist Devices*
  • Humans
  • Interdisciplinary Communication*
  • Intestinal Fistula / surgery
  • Male
  • Mediastinal Diseases / surgery
  • Middle Aged
  • Patient Care Team*
  • Postoperative Complications / surgery*
  • Postoperative Hemorrhage / surgery
  • Prosthesis-Related Infections / surgery
  • Reconstructive Surgical Procedures*
  • Reoperation
  • Surgical Flaps*
  • Surgical Wound Infection / surgery*