Utility of Cardiac Computed Tomography in Patients with Left Ventricular Assist Devices
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Purpose of Review
The number of left ventricular assist device implants has increased significantly in the last decade. Left ventricular assist device (LVAD) optimization, trouble-shooting complications, and surgical planning require a multi-modality imaging approach. Echocardiography remains the imaging modality of choice, particularly for physiological evaluation but accurate anatomical evaluation of the entirety of the LVAD is often challenging if not impossible. Cardiac computed tomography (CCT) offers additional information that is valuable in taking care of these complex patients. The purpose of this review is to understand the nuances of LVAD imaging and areas where CCT can aid LVAD evaluation and management.
CCT has a well-established role in trouble-shooting complications particularly inflow and outflow cannula-related anatomic complications from suction and kinking. Even though the literature is scarce, there is evolving data to suggest that adverse inflow and outflow cannula positions may result in unfavorable outcomes. There is more interest in novel mechanisms of device implantation and planning for which data set from CCT is ideal. Functional evaluation of the right ventricle with CCT is becoming more sophisticated and maybe particularly useful in this patient population. Development in CCT technology has helped minimize safety concerns and improved image quality with reduction in LVAD-related artifacts.
CCT is an important adjunct modality to echocardiography for patients with LVAD. Information obtained from CCT may help our understanding of LVAD and in turn help reduce and managed LVAD-related complications.
KeywordsCardiac computed tomography Left ventricular assist device Surgical planning LVAD complications Safety Artifact reduction
Compliance with Ethical Standards
Conflict of Interest
Dr. Chang is recipient of a Houston Methodist –Siemens Research Collaborative Grant.
Dr. Ramirez Giraldo is an employee of Siemens HealthCare.
All other authors declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major Importance
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