Author + information
- Received February 3, 2019
- Revision received May 13, 2019
- Accepted May 24, 2019
- Published online April 6, 2020.
- Zaid I. Almarzooq, MBBCha,∗,
- Anubodh S. Varshney, MDa,∗,
- Muthiah Vaduganathan, MD, MPHa,
- Manan Pareek, MD, PhDa,b,
- Garrick C. Stewart, MDa,
- Jerry D. Estep, MDc and
- Mandeep R. Mehra, MD, MSca,∗ (, )@MRMehraMD
- aBrigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, Massachusetts
- bDepartment of Cardiology, Nephrology, and Endocrinology, North Zealand Hospital, Hillerød, Denmark
- cDepartment of Cardiovascular Medicine and the Heart and Vascular Institute, Kaufman Center for Heart Failure, Cleveland Clinic, Cleveland, Ohio
- ↵∗Address for correspondence:
Dr. Mandeep R. Mehra, Brigham and Women’s Hospital Heart and Vascular Center, Center for Advanced Heart Disease, 75 Francis Street, Boston, Massachusetts 02115.
• Several advances in LVAS require an updated perspective of multi-modality imaging.
• Multimodality imaging of LVAS includes echocardiography, CT, and nuclear imaging.
• As LVAS use increases globally, understanding the roles of the various imaging modalities will be critical.
An increasing number of patients transition to advanced-stage heart failure refractory to medical therapy. Left ventricular assist systems (LVAS) provide a bridge to candidates awaiting heart transplantation and extended device durability allows permanent implantation referred to as destination therapy. Noninvasive imaging plays a pivotal role in the optimal management of patients implanted with durable mechanical circulatory support (MCS) devices. Several advances require an updated perspective of multi-modality imaging in contemporary LVAS management. First, there has been substantial evolution of devices such as the introduction of the fully magnetically levitated HeartMate 3 pump (Abbott, Abbott Park, Illinois). Second, imaging beyond the device, of the peripheral system, is increasingly recognized as clinically relevant. Third, U.S. Food and Drug Administration recalls have called attention to LVAS complications beyond pump thrombosis that are amenable to imaging-based diagnosis. Fourth, there is increased availability of multimodality imaging, such as computed tomography and positron emission tomography, at many centers across the world. In this review, the authors provide a practical and contemporary approach to multi-modality imaging of current-generation durable MCS devices. As the use of LVAS and other novel MCS devices increases globally, it is critical for clinicians caring for LVAS patients to understand the roles of various imaging modalities in patient evaluation and management.
↵∗ Drs. Almarzooq and Varshney are co-first authors of this paper.
Dr. Vaduganathan is supported by the KL2/Catalyst Medical Research Investigator Training award from Harvard Catalyst (NIH/NCATS Award UL 1TR002541), and serves on Advisory Boards for Amgen, AstraZeneca, Bayer AG, Baxter Healthcare, and Boehringer Ingelheim. Dr. Pareek serves on an advisory board for AstraZeneca; and has received speaker honoraria from AstraZeneca, Bayer, and Boehringer Ingelheim. Dr. Estep is a consultant and medical advisor for Abbott and Medtronic. Dr. Mehra is a consultant for Abbott, Medtronic, Janssen (a division of Johnson and Johnson), Stealth Biotherapeutics, Teva (now Mesoblast), NupulseCV, Inc., Portola, Xogenex, Bayer; and is on the Scientific Advisory Board for NupulseCV and FineHeart. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 3, 2019.
- Revision received May 13, 2019.
- Accepted May 24, 2019.
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