Early F-18-FDG-PET/CT-guided surgical therapy in left ventricular assist device infection reduces hospital stay during follow-up

Ziel/Aim:

Left-ventricular assist devices (LVAD) are vulnerable to infections. F-18-Fluorodeoxyglucose (FDG)-PET/CT is increasingly used to guide surgical or anti-infectious intervention. We sought to obtain insights into the effect on patient management.

Methodik/Methods:

57 LVAD-carrying patients received 85 whole-body F-18-FDG-PET/CT scans. Clinical follow-up was obtained over a period of up to two years after each scan, or until hard event or next scan.

Ergebnisse/Results:

All 85 scans were positive for LVAD infection involving a combination of driveline (n = 79), pump pocket (n = 42) and outflow tract (n = 49) components. PET scan results were not associated with hard events (death, transplant). Three groups were identified: Those who had early surgical revision < 80 d after PET, those with late surgical revision and those without surgical revision. During follow up, those with delayed revision spent afterwards significantly (p < 0.05) more time in hospital than those with early revision.

Schlussfolgerungen/Conclusions:

If early surgical intervention for LVAD infection is feasible and guided by FDG-PET/CT, this may reduce the subsequent need for hospital admission and thus reduce clinical costs. Further work in larger samples is needed to define the value of PET for LVAD patient management and outcome.