Introduction:
Long-term ventricular assist device (LVAD) implantation and heart transplantation changed forever therapeutic approach in patients with advanced heart failure and confirmed impact in REMATCH trial1. Despite progressive improvement in perioperative care and device technology such as smaller implantable pumps instead of paracorporeal devices infectious complications (IC) remain one of the main causes worsening both short-term and long-term prognosis2. Our retrospective analysis of LVAD implantations between 2003 and 2012 identified IC as the most life-threatening complication in postoperative period3. Importantly, these complications increase hospitalization costs4.
However, early and accurate diagnosis of IC in LVAD patients is challenging due to serious preoperative status with organ dysfunction and systemic inflammatory response syndrome (SIRS) after surgery caused by cardiopulmonary bypass (CPB)5. Among available biomarkers, procalcitonin (PCT) proved superiority over other inflammatory markers such as C-reactive protein after routine non-LVAD cardiac surgery6,7,8,9,10,11. But our preliminary prospective data from small cohort showed that ability of PCT to detect IC after LVAD implantation could be limited12. In this respect, presepsin (PSEP) is another promising novel biomarker for diagnosis of a bacterial infection13. The aim of this study was to assess PCT and PSEP dynamics after LVAD implantation and its relationship to IC in the early post-operative period.