Background: Infection is an infrequent but major complication of cardiovascular device implantation.
Hypothesis: Treatment of patients with cardiovascular implant infection with antibiotic therapy and removal of the device is superior to antibiotic therapy alone.
Methods: Medical records were reviewed for dogs that received a cardiovascular device from June 2001 to August 2006 at the University of Minnesota Veterinary Medical Center and the University of Missouri Veterinary Medical Teaching Hospital.
Results: Six of 63 (9.5%) pacemaker systems and 2 of 47 (4.3%) patent ductus arteriosus (PDA) occlusion devices became infected. Median time from procedure to diagnosis of implant infection was 62 days (range, 5 to 419). Median age of dogs with pacemaker infections was 8.5 years (range, 6.2 to 11.9). Pseudomonas aeruginosa and Staphylococcus spp were the most commonly cultured isolates. Four dogs were treated with antibiotics and pacemaker replacement. All 4 recovered completely from their infections. One was alive at the end of the study period, and 3 had been euthanized. However, the reasons for euthanasia were unrelated to pacemaker infection. In contrast, both dogs with infected pacemakers that were treated with antibiotics alone were euthanized because of complications attributable to infection. Infection of PDA occlusion devices occurred in puppies < 16 weeks of age, and Pasteurella spp were isolated from both. One was successfully treated with a combination of antibiotics and surgery, and the other was euthanized without treatment.
Conclusions and clinical importance: Antibiotic therapy alone is associated with chronic complications in patients with cardiovascular implants and is unlikely to effect a cure.