Pre- and postoperative appearance of a severe driveline infection

(Panel A) Complex driveline infection diagnosed 4 years after left ventricular assist device implantation. The findings include driveline erosion out of the abdominal wall, extensive soft tissue destruction with multiple abdominal wall sinuses, and a wide area of abdominal wall erythema.

(Panel B) Postoperative appearance after pump exchange and relocation of the driveline tract to the left upper quadrant. The abdominal wall was debrided and managed initially with a vacuum dressing and then secondary closure.