Comprehensive Cardiac Imaging Before and During Microaxial Flow Pump Support for Cardiogenic Shock

The increasing use of microaxial flow pumps (mAFP) underpins the need for a comprehensive approach to manage critically ill patients in an effort to maximize the benefits of this temporary mechanical circulatory support (tMCS) while minimizing its potential complications. Multimodality cardiac imaging offers an irreplaceable array of tools to address device position, device-heart hemodynamic interaction, myocardial recovery assessment, and identification of complications. This review provides a comprehensive and pragmatic summary of the cardiovascular imaging modalities currently available throughout the pathway of care of mAFP-supported patients, from device insertion, to intensive cardiac care hemodynamic monitoring, weaning guidance, and myocardial recovery assessment. The specific logistical and technical challenges related to pump management and potential interference with the imaging technology performed during mAFP are also discussed. Comprehensive cardiovascular imaging represents a fundamental pillar to ensure the best care to mAFP-supported patients and plays a pivotal role in any successful critical care and tMCS program.