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Expanding the Scope of Multimodality Imaging in Durable Mechanical Circulatory Support

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  • Zaid I Almarzooq
  • Anubodh S Varshney
  • Muthiah Vaduganathan
  • Manan Pareek
  • Garrick C Stewart
  • Jerry D Estep
  • Mandeep R Mehra
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An increasing number of patients transition to advanced-stage heart failure refractory to medical therapy. Left ventricular assist systems (LVAS) provide a bridge to candidates awaiting heart transplantation and extended device durability allows permanent implantation referred to as destination therapy. Noninvasive imaging plays a pivotal role in the optimal management of patients implanted with durable mechanical circulatory support (MCS) devices. Several advances require an updated perspective of multi-modality imaging in contemporary LVAS management. First, there has been substantial evolution of devices such as the introduction of the fully magnetically levitated HeartMate 3 pump (Abbott, Abbott Park, Illinois). Second, imaging beyond the device, of the peripheral system, is increasingly recognized as clinically relevant. Third, U.S. Food and Drug Administration recalls have called attention to LVAS complications beyond pump thrombosis that are amenable to imaging-based diagnosis. Fourth, there is increased availability of multimodality imaging, such as computed tomography and positron emission tomography, at many centers across the world. In this review, the authors provide a practical and contemporary approach to multi-modality imaging of current-generation durable MCS devices. As the use of LVAS and other novel MCS devices increases globally, it is critical for clinicians caring for LVAS patients to understand the roles of various imaging modalities in patient evaluation and management.

Original languageEnglish
JournalJACC. Cardiovascular imaging
Issue number4
Pages (from-to)1069-1081
Number of pages13
Publication statusPublished - Apr 2020

Bibliographical note

Copyright © 2020. Published by Elsevier Inc.

ID: 58048896