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Updated: Jan 26, 2026

In Vitro Thrombosis Test for Ventricular Assist Devices
Published on: March 21, 2025
Typical but uncommon computed tomography angiographic appearance of left ventricular assist device: Awareness is key!
Priya Sarv1, Watal Pankaj1, Staron Michelle2
1Department of Radiology, University of Iowa Hospitals & Clinics, IA, USA.
Insights
Computed tomography angiography (CTA) can reveal a normal appearance around HeartWare left ventricular assist devices (LVAD) that may mimic thrombus. Awareness of this imaging finding prevents unnecessary interventions for LVAD patients.
Area of Science:
- Cardiology
- Medical Imaging
- Biomedical Engineering
Background:
- Left ventricular assist devices (LVADs) are crucial for end-stage heart failure patients awaiting transplantation.
- HeartWare LVADs are increasingly used, necessitating clear understanding of their imaging characteristics.
- Misinterpretation of imaging findings can lead to inappropriate clinical decisions.
Abstract:
Left ventricular assist devices (LVAD) are now a standard of care for patients awaiting heart transplant. Our patient had undergone placement of the HeartWare LVAD and presented to the hospital with complaints of fatigue, dyspnea, fever and discharge from the LVAD site. She underwent computed tomography angiography (CTA) to evaluate the LVAD. CTA revealed a hypodense area surrounding the outflow graft throughout its extent. This was suspicious of a thrombus. The repeat CTA performed 4 days later did not show any change in appearance of the outflow graft. This appearance was in fact due to the co-axial relationship of the two outflow grafts creating a potential space between them that can be filled with blood. This is a normal appearance and should not be mistaken for a thrombus. The awareness of the normal imaging appearance of the LVAD devices is essential to avoid unnecessary surgical intervention.
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