Echocardiographic Evaluation of Ventricular Assist Devices

Abstract

Ventricular assist devices (VAD) are used to treat selected patients with severe heart failure and their role in this field is expanding. Indications for VAD insertion include bridge to transplant, bridge to decision, bridge to recovery and destination therapy. Due to their complicated mechanical structure and function and interaction with complex patients, echocardiography plays a key role in managing patients supported with a VAD. Echocardiography is integral in four areas; pre-operative assessment of potential candidates, guidance during VAD insertion, detection of complications and monitoring for cardiac recovery. Transthoracic echocardiography is the initial imaging modality used. However, trans-oesophageal echocardiography is usually required for a more detailed cardiac examination. Intracardiac echocardiography (ICE), contrast enhanced echocardiography and epicardial echocardiography may used in specific cases.