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. 2025 Apr 4:8:100264.
doi: 10.1016/j.jhlto.2025.100264. eCollection 2025 May.

Omentoplasty for ventricular assist device infections: Encouraging outcomes

Ahmed M El Banayosy  1 , Susan George  1 , David W Vanhooser  1 , Hendra Setiadi  1 , Daniel R Freno  1 , Marshall T Bell  1 , Craig C Elkins  1 , Mircea R Mihu  1 , Douglas A Horstmanshof  1 , Aly El Banayosy  1 , James W Long  1
Affiliations

Omentoplasty for ventricular assist device infections: Encouraging outcomes

Ahmed M El Banayosy et al. JHLT Open. .

Abstract

Background: LVAD infections are associated with substantial morbidity and mortality. We explored the impact of surgical Omentoplasty (OMP) added to Incision and Debridement (I&D) plus Antibiotic therapy (AB) on survival and infection-related readmissions in patients with LVAD infections.

Methods: Thirty-three patients with deep LVAD-specific infections were studied over a period of 12 years. Survival and readmissions for recurrent infection in subjects receiving I&D and ABs alone (Group A, n = 15) were compared to those in whom OMP was added to I&D and ABs (Group B, n = 18).

Results: Baseline characteristics were similar between groups, as well as infectious organisms. Two-year survival was significantly improved in Group B (OMP + I&D + ABs) as compared to Group A (I&D + ABs without OMP) [77% vs. 7%; p < 0.001]. Recurrent infection-related readmissions were notably lower in Group B compared to Group A (0.18 vs. 0.24 admissions/patient-year), with a significant reduction within Group B following the application of OMP (0.13 to 0.06 admissions/patient-year). Following OMP, intravenous (IV) antibiotics were successfully replaced with oral long-term ABs in the 78% of patients. No long-term antibiotic-related complications were noted.

Conclusion: This report, comprising the most extensive such experience to date, indicates that combining surgical Omentoplasty (OMP) with incision and debridement (I&D) plus antibiotic (AB) treatment is remarkably effective for suppressing deep LVAD infections, improving survival and decreasing infection-related readmissions. Filling the open space around an implanted LVAD with highly vascularized omentum, as a living tissue with anti-infective properties, appears to be effective for improving outcomes with LVAD infections.

Keywords: Driveline Infection; Omental Flap; Omental Wrap; Omentum; Pump Infection; VAD.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Douglas A. Horstmanshof reports a relationship with Abbott Medical that includes: consulting or advisory and speaking and lecture fees. Aly El Banayosy reports a relationship with Abbott Medical that includes: consulting or advisory. James W. Long reports a relationship with BrioHealth Solutions that includes: consulting or advisory. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Two-year Kaplan-Meier (KM) survival curves for Group A (without OMP) versus Group B (with OMP). P value generated by log-rank test. OMP, Omentoplasty.
See this image and copyright information in PMC

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