Covering implantable left ventricular assist device (DuraHeart?) with free flap

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• 作者：Ken Matsuda ; Akimitsu Nishibayashi ; Koichi Toda…
• 关键词：LVAD ; Infection ; Exposure ; Free flap ; Continuous flow
• 刊名：Journal of Artificial Organs
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：18
• 期：2
• 页码：114-119
• 全文大小：2,131 KB
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• 作者单位：Ken Matsuda (1)
  Akimitsu Nishibayashi (2)
  Koichi Toda (3)
  Takashi Fujiwara (2)
  Megumi Fukai (2)
  Daisuke Yoshioka (3)
  Yoshiki Sawa (3)
  Ko Hosokawa (2)
  
  1. Division of Plastic and Reconstructive Surgery, Niigata University Graduate School of Medicine, 1-757, Asahimachi-Dori, Chuo-ku, Niigata, 951-8510, Japan
  2. Department of Plastic and Reconstructive Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
  3. Department of Cardiovascular Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Cardiac Surgery
  Biomedical Engineering
  Orthopedics
  Nephrology
  Hepatology
  
• 出版者：Springer Japan
• ISSN：1619-0904

文摘

Severe donor shortage in Japan makes the waiting period for heart transplantation extremely long and the left ventricular assist devices (LVADs) are often used for bridge-to-transplant. We present three cases of infected and exposed DuraHeart? LVAD system treated with free flaps. Four free flaps (two latissimus flaps and two anterolateral thigh flaps) were transferred using the right internal thoracic vessels or left deep inferior epigastric vessels as recipients. The potential significance of the continuous low pressure blood flow generated by the LVAD system on microvascular patency has not been previously reported. All flaps survived and worked efficiently to control the infection and cover the devices. Heart transplantation was conducted in the two of three patients. Free flap transfer is an efficient treatment for the patients with infected and exposed implantable LVAD.