Complex HeartMate II infection treated with pump exchange to HeartWare HVAD.

Left ventricular assist device (LVAD) infections continue to present a serious challenge in both the destination therapy and the bridge to transplant patient populations. As devices are supporting patients longer due to increased durability, infections can evolve and worsen over time. Complex infections, resistant to standard pharmacologic management, require a more aggressive approach to treatment. A series of patients supported by HeartMate II (HMII) LVADs, treated for multidrug resistant complex driveline infections, failed antibiotic therapy and then underwent device exchange. In each case, the HMII device was exchanged for a HeartWare HVAD as we felt its small size and flexible driveline were advantageous properties when dealing with patients with a complex driveline or pump infection.