SPECT/CT Assessment of Infected Intracardiac Devices With and Without Attenuation Correction

Left ventricular assist devices (LVADs) provide the ability to maintain cardiac output and sustain life as a bridge to transplantation, definitive therapy, or a permanent decision. We present a case of LVAD drive infection that was differentiated from pump infection by the use of attenuation-corrected and non-attenuation-corrected CT, along with correlation with the planar images. Clinically, the patient was suspected of having infection; however, the clinician did not know which components of the device were involved. The patient's scan showed abnormal activity along the driveline with and without attenuation correction, whereas the pump showed abnormal activity with attenuation correction only. This finding suggested that the drive line was infected but that the activity within the pump was secondary to overcorrection of attenuation. The driveline was cultured, confirming infection.