Abstract
OBJECTIVES: Driveline infection remains a major complication of long-term ventricular assist device therapy. Previous studies have associated the risk of infection with driveline design and physical properties. The CH-VAD is a fully magnetically levitated pump with an ultrathin (diameter 3.3 mm), highly flexible driveline designed to reduce infection risk. This study was conducted to assess the incidence, risk factors, and approaches to prevention and management of driveline infection in CH-VAD patients (NCT06878456). METHODS: All patients who underwent CH-VAD implantation between June 2017 and October 2024 at 9 centres were retrospectively analysed. Data related to clinical characteristics, surgical procedures, and driveline infection prevention and management details were collected, and risk factors were analysed. RESULTS: A total of 181 consecutive patients were included, with a median age of 56 years and 86% male. During a median support duration of 1.6 years, driveline infections occurred in 20 out of 181 patients (11.0%). Twenty-six events were observed, corresponding to a rate of 0.07 events per patient-year. Cumulative incidence of the first driveline infection was 2.8% at 6 months, 5.6% at 12 months, and 8.5% at 24 months. Frequent dressing changes were found to be significantly associated with increased driveline infection risk (HR 3.773, P = .022). CONCLUSIONS: Patients treated with CH-VADs experienced an encouraging low rate of driveline infection, considered among the lowest reported for durable ventricular assist devices. These findings have implications for both clinical management and driveline design.