CT Imaging of Complications Associated with Continuous-Flow Left Ventricular Assist Devices (LVADs)

Area of Science:

• Cardiology
• Radiology
• Medical Imaging

Background:

• Heart failure prevalence is rising, leading to increased use of left ventricular assist devices (LVADs).
• Continuous-flow LVADs are becoming more common for bridge-to-transplant and destination therapy.
• LVAD implantation is associated with significant complications, including bleeding, thrombosis, and infection.

Purpose of the Study:

• To highlight the utility of computed tomography (CT) in diagnosing complications associated with LVADs.
• To emphasize the role of radiologists in managing patients with LVADs.

Main Methods:

• Review of CT imaging findings in patients with LVADs.
• Identification of common and uncommon LVAD-related complications visible on CT scans.
• Correlation of imaging findings with clinical outcomes.

Main Results:

• CT effectively diagnoses various LVAD complications: mediastinal hematomas, various hemorrhages (pericardial, abdominal, retroperitoneal), graft and aortic thrombi, and driveline/pump pocket infections.
• CT can identify device malfunctions such as outflow graft kinking and inflow cannula misalignment.
• Radiologists must differentiate implanted device materials from hemorrhage or calcification on CT.

Conclusions:

• CT imaging is an essential tool for evaluating patients with LVADs.
• Accurate interpretation of CT scans is vital for timely diagnosis and management of LVAD complications.
• Radiologists play a key role in optimizing care for patients undergoing LVAD therapy.