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.