RESUMEN
Persistent infection of left ventricular-assisted devices are challenging to treat. We describe a case of a middle-aged man who presented with cardiogenic shock and profound heart failure from sarcoid myocarditis, necessitating the placement of a left ventricular assist device. After recovery of cardiac function, the device was decommissioned but complicated by infection in the implant bed, chest wall, and of the titanium plug left in situ. This to our knowledge is the first report of an infected titanium plug and we describe an option of using a latissimus dorsi flap using its vascularized tissues to treat the infected plug. This is another example where a multidisciplinary approach can yield rewarding results in cases such as these.
Asunto(s)
Procedimientos Quirúrgicos Cardíacos/métodos , Remoción de Dispositivos/métodos , Insuficiencia Cardíaca/etiología , Ventrículos Cardíacos/cirugía , Corazón Auxiliar/efectos adversos , Miocarditis/microbiología , Miocarditis/cirugía , Infecciones Relacionadas con Prótesis/etiología , Infecciones Relacionadas con Prótesis/cirugía , Choque Cardiogénico/etiología , Titanio/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Miocarditis/etiología , Diseño de Prótesis , Recuperación de la Función , Colgajos Quirúrgicos , Resultado del TratamientoRESUMEN
We report a 3-year-old boy weighing 13.5 kg who presented with intractable cardiac failure resulting from myocarditis and was treated by implantation of a HeartWare (HVAD) device. He was discharged home with the device. His cardiac function subsequently recovered, and the device was decommissioned. We believe this to be the youngest HVAD recipient and the only child to have recovered and had the device decommissioned.