Elsevier

Journal of Nuclear Cardiology

Volume 30, Issue 6, December 2023, Pages 2823-2824
Journal of Nuclear Cardiology

Images That Teach
Left ventricular assist device infection on 18F-flourodeoxyglucose positron emission tomography

https://doi.org/10.1007/s12350-023-03258-8Get rights and content

Abstract

The rising prevalence of heart failure with limited transplant availability has resulted in increased use of continuous left ventricular assist device (LVAD) support. LVAD driveline remains exposed to environment which predisposes it to high rates of infection. We describe a case of a persistent driveline infection in a patient for which 18F-FDG PET/CT was utilized to diagnose deep-seated infection.

Section snippets

Case presentation

A 32-year-old female with a history of heparin-induced thrombocytopenia, peripartum cardiomyopathy requiring ICD placement 2015, followed by mitral valve repair with Duran Mitral Valve Annuloplasty ring #25, tricuspid valve repair with Carpentier-Edwards tricuspid ring #26, implantable cardioverter defibrillator, and implantation of HeartMate 3 LVAD four years prior as a bridge to heart transplantation. Post-operative course was complicated by polymicrobial infections due to Pseudomonas

Discussion

  • Deep LVAD-related infections can be difficult to diagnose and have high rates of morbidity and mortality. Traditional imaging such as TEE and CT are poor predictors of LVAD infection as was observed in our case.1 This patient had persistent LVAD infection that extended beyond the driveline and was successfully diagnosed utilizing 18F-FDG PET/CT. In a case series of nine patients with clinically suspected LVAD infection, 18F-FDG PET/CT was beneficial in localizing the site and defining extent of

Teaching points

  • 18F-FDG PET/CT has emerged as an important imaging technology used to detect LVAD-related infections

  • Timing of 18F-FDG PET/CT is crucial as immediately post surgery (6 weeks) it can result in false-positive results

References (2)

  • Zinoviev R, Lippincott CK, Keller SC, Gilotra NA. full flow: left ventricular assist device infections in the modern...
  • Tam MC, Patel VN, Weinberg RL, Hulten EA, Aaronson KD, Pagani FD, et al. Diagnostic accuracy of FDG PET/CT in suspected...

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