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Left Ventricular Assist Devices: Advances, Complications, and Pitfalls.

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Left ventricular assist devices (LVADs) require imaging for complication detection. Contrast-enhanced chest CT is the preferred method for evaluating outflow graft issues in patients with these cardiac assist devices.

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Area of Science:

  • Radiology
  • Cardiology
  • Medical Imaging

Background:

  • Left ventricular assist devices (LVADs) support patients with end-stage systolic heart failure.
  • Imaging is vital for assessing LVAD implantation suitability and detecting post-implantation complications.
  • Complications can involve the pump, cannulas, graft, or driveline.

Purpose of the Study:

  • To describe CT findings and complications associated with LVADs.
  • To highlight contrast-enhanced chest CT as the preferred modality for evaluating outflow graft complications.
  • To focus on HeartMate II and HeartMate 3 devices, with mention of the recalled HeartWare device.

Main Methods:

  • Review of CT imaging findings in patients with LVADs.
  • Focus on complications related to inflow and outflow pathways.
  • Discussion of specific device types: HeartMate II, HeartMate 3, and HeartWare.

Main Results:

  • Contrast-enhanced chest CT is effective for diagnosing LVAD complications, particularly outflow graft issues.
  • Echocardiography has limitations in visualizing internal cannula structures.
  • MRI is contraindicated in patients with LVADs.

Conclusions:

  • CT imaging is crucial for identifying and managing LVAD-associated complications.
  • Understanding CT findings aids in patient management and device assessment.
  • This essay serves as a guide to CT imaging of LVADs.