Author + information
- Rey P. Vivo, MD∗,†,
- Mahwash Kassi, MD∗,
- Jerry D. Estep, MD∗,
- Arvind Bhimaraj, MD, MPH∗,
- Barry H. Trachtenberg, MD∗,
- Carlos M. Orrego, MD∗,
- Matthias Loebe, MD, PhD∗,
- Brian A. Bruckner, MD∗,
- Faisal Nabi, MD∗,
- John J. Mahmarian, MD∗,
- William A. Zoghbi, MD∗ and
- Su Min Chang, MD∗∗ ()
- ∗Methodist DeBakey Heart and Vascular Center, The Methodist Hospital, Houston, Texas
- †Department of Cardiology, University of Texas Medical Branch, Galveston, Texas
- ↵∗Reprint requests and correspondence:
Dr. Su Min Chang, Methodist DeBakey Heart & Vascular Center, 6550 Fannin Street, Suite 677, Houston, Texas 77030.
THE RISING NUMBER OF PATIENTS WITH ADVANCED HEART FAILURE WHO RECEIVE DURABLE MECHANICAL CIRCULATORY SUPPORT (MCS) DEVICES requires improved recognition of device complications (1). Imaging is invariably needed because the clinical presentation is nonspecific. In our institution, we perform both a baseline echocardiographic study and a pump speed optimization test when left ventricular assist device (LVAD) dysfunction is suspected (2). Additionally, we obtain a contrast electrocardiogram (ECG)-gated multidetector cardiac computed tomography (MDCT) study to screen for complications in patients without significant impaired kidney function. With fast acquisition, superior spatial resolution, and superior image quality, ECG-gated MDCT could directly visualize the entire MCS systems (except for the pump interior) and surrounding anatomy from multiple views (Figure 1), albeit with some radiation/contrast exposure. This iPIX illustrates the utility of MDCT in diagnosing a spectrum of post-implant complications, including cannula complications (Figure 2, Online Video 1), pump and aortic root thrombosis (Figure 3 and 4), and surgical emergencies, among patients supported with LVAD, biventricular assist device, and total artificial heart (Figure 5, Online Videos 2 and 3).
Dr. Estep is a consultant for and receives speakers fees from Thoratec Corp. Dr. Chang has received a research grant from Astellas. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- 2015 American College of Cardiology Foundation