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LVAD Driveline Infection — SCE Infectious Diseases MCQ

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HardHealthcare-Associated InfectionsLVAD Driveline InfectionSCE Infectious Diseases

A 55-year-old man with a ventricular assist device (LVAD) develops a driveline exit-site infection. Culture grows MRSA. What is the unique challenge of driveline infections?

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Correct answer: D — The driveline cannot be removed without replacing the entire LVAD — prolonged/suppressive antibiotics with meticulous wound care are the mainstay; device exchange is reserved for severe/refractory infections

LVAD driveline infections present unique management challenges because the driveline percutaneously exits the body (permanent skin breach) and cannot be removed independently of the LVAD. Management includes: targeted antibiotics (IV then oral suppressive therapy — often long-term or indefinite), meticulous exit-site wound care, and surgical driveline relocation or revision if possible. Severe/refractory infections may require LVAD exchange or cardiac transplantation. Driveline infections can lead to pump pocket infections, bacteraemia, and endocarditis.

Reference: AHA 2024 – LVAD infections; ISHLT 2023 – MCS device infections