[Reconstructive surgery in patients with a ventricular assist device (VAD)--an interdisciplinary challenge]. / Rekonstruktive Chirurgie bei Patienten mit Herzunterstützungssytemen (Ventricular Assist Device, VAD)--eine interdisziplinäre Herausforderung.

BACKGROUND: Ventricular assist devices (VAD) are implanted with a growing frequency in patients with end-stage heart failure. In spite of technical and therapeutic advances, there is still a high incidence of device infections and healing disturbances with a considerable mortality. Reconstructive plastic surgery is able to provide help in erradicating infections and covering defects. PATIENTS AND METHODS: 11 patients with device infections and soft tissue defects were treated in our institution. All cases were treated with local myocutaneous or muscle flaps. RESULTS: Three patients had postoperative haematomas which had to be revised surgically. One patient had a persistent fistula of mediastinal origin but without clinical symptoms of infection. One patient exhibited an enterocutaneous fistula after defect coverage. CONCLUSION: Patients with VADs have a high possibility of perioperative complications. Therefore a close interdisciplinary approach with plastic and cardiovascular surgeons is absolutely essential.