Left Ventricular Assist Devices: Advances, Complications, and Pitfalls

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.