Long-term medical control of inflow cuff infection in a patient with a left ventricular assist system.

We report on a patient fitted with a Toyobo left ventricular assist system who developed inflow cannula exit-site infection. Although the exit-site infection seemed to be overcome by local irrigation and intravenous antibiotic therapy, repeated attempts at discontinuation of the intravenous antibiotic therapy resulted in bacteremia, and long-term administration of intravenous antibiotics was required. At the time of heart transplantation, it was noticed that the exit-site infection had caused ascending infection via the cannula and resulted in abscess formation around the left ventricular apical cuff. The infection was successfully controlled by heart transplantation and prophylactic omentopexy.