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| ID | Type | Description | Link |
|---|---|---|---|
| 5P50HL077096 | U.S. NIH Grant/Contract | View source |
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| Name | Class |
|---|---|
| National Heart, Lung, and Blood Institute (NHLBI) | NIH |
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Infections often occur after ventricular assist devices (VADs) are placed. These infections can be very serious. The goal of this study is to understand why these infections occur. Bacteria (germs) normally live on our skin and in our noses. After surgery, they can infect the VAD. The investigators will collect cultures of your skin and nose before and after surgery. The investigators will compare these bacteria to bacteria that cause infections. Their genes will be compared to see which ones help the bacteria cause infection.
Infections are one of the most serious of ventricular assist device (VAD) related complications. Many of these infections are associated with significant patient morbidity and mortality. Diagnosis of these infections is often difficult due to the complicated nature of the patient's medical problems, the need for rapid institution of empiric antibiotic therapy and the lack of established criteria that define infection. Staphylococci are among the most common causes of VAD infections. The basis for this high incidence is not well understood but is believed to be in part due to inoculation of staphylococcal commensal flora into wound sites at the time of surgery or thereafter. The goals of this observational study are to develop a better understanding of the pathogenesis and epidemiology of Staphylococcus aureus and epidermidis-VAD infections as well as to develop a set of criteria that can be used to help diagnose the presence or absence of a VAD related infection.
This is a prospective, multi-center, observational study to identify risk factors associated with the development of VAD-related infections. Patients will be followed for up to one year following VAD implantation, time of death or transplantation, whichever comes first. There will be no randomization for this observational study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study Population | 150 subjects with end-stage heart failure who have been scheduled to undergo device implantation with a VAD, either as a bridge to cardiac transplantation or for destination therapy. |
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| Measure | Description | Time Frame |
|---|---|---|
| The incidence of suspected infections, characterized by infecting organism and location. | The primary goal is to collect information that describes infections in patients receiving LVADs. | Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first. |
| Measure | Description | Time Frame |
|---|---|---|
| Collect and quantify culture results for suspected infections and the secondary manifestations of infection | Bacteria normally live on our skin and in our noses.After surgery, they can infect the VAD. We will collect cultures before and after surgery and compare these bacteria to bacteria that cause infections.Their genes will be compared to see which ones help the bacteria cause infection. We hope this will help develop new ways to help prevent VAD infections. |
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Inclusion Criteria:
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Patients with end-stage heart failure who demonstrate the need for intermediate or long-term support with a VAD.
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| Name | Affiliation | Role |
|---|---|---|
| Patrice Desvigne-Nickens | National Heart, Lung, and Blood Institute (NHLBI) | Study Director |
| Yoshifumi Naka, MD | Columbia University | Study Chair |
| Michael Parides, PhD | Icahn School of Medicine at Mount Sinai | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Alabama at Birmingham | Birmingham | Alabama | 35294 | United States | ||
| Sharp Memorial Hospital |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 23315371 | Derived | Gordon RJ, Weinberg AD, Pagani FD, Slaughter MS, Pappas PS, Naka Y, Goldstein DJ, Dembitsky WP, Giacalone JC, Ferrante J, Ascheim DD, Moskowitz AJ, Rose EA, Gelijns AC, Lowy FD; Ventricular Assist Device Infection Study Group. Prospective, multicenter study of ventricular assist device infections. Circulation. 2013 Feb 12;127(6):691-702. doi: 10.1161/CIRCULATIONAHA.112.128132. Epub 2013 Jan 11. | |
| 22457291 | Derived | Gordon RJ, Miragaia M, Weinberg AD, Lee CJ, Rolo J, Giacalone JC, Slaughter MS, Pappas P, Naka Y, Tector AJ, de Lencastre H, Lowy FD. Staphylococcus epidermidis colonization is highly clonal across US cardiac centers. J Infect Dis. 2012 May 1;205(9):1391-8. doi: 10.1093/infdis/jis218. Epub 2012 Mar 29. |
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| Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first. |
| Develop Guidelines to properly diagnose VAD infections | Information will be collected on patient's medical condition after surgery including blood tests to help determine if an infection is present. | Up to one year following VAD implantation, time of death or transplantation, whichever comes first. |
| Costs (direct) | The value of all resources that are consumed in the provision of an intervention or dealing with the side-effects or other current and future consequences linked to it. | Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first. |
| Adverse Events | Since this is an observational study there will be no adverse events directly attributable to a study intervention. However, adverse events that might potentially contribute to the risk or course of VAD-related infections will be monitored. | Duration of the study, up to one year following VAD implantation, time of death or transplantation, whichever comes first. |
| San Diego |
| California |
| 92123 |
| United States |
| Advocate Christ Medical Center | Oak Lawn | Illinois | 60453 | United States |
| Jewish Hospital | Louisville | Kentucky | 40202 | United States |
| University of Michigan | Ann Arbor | Michigan | 48109 | United States |
| University of Minnesota | Minneapolis | Minnesota | 55455 | United States |
| Columbia Presbyterian Medical Center | New York | New York | 10032 | United States |
| Montefiore Medical Center | The Bronx | New York | 10467 | United States |
| Hospital of the University of Pennsylvania | Philadelphia | Pennsylvania | 19104 | United States |
| LDS Hospital | Salt Lake City | Utah | 84143 | United States |
| Sacred Heart Medical Center | Spokane | Washington | 99204 | United States |
| University of Wisconsin Hospital | Madison | Wisconsin | 53792 | United States |
| St. Luke's Medical Center | Milwaukee | Wisconsin | 53215 | United States |
| ID | Term |
|---|---|
| D006333 | Heart Failure |
| ID | Term |
|---|---|
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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