Skip to main content
SpringerLink
Log in

Conventional radiography and computed tomography of cardiac assist devices

  • Cardiac
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

Patients intended for circulatory support by cardiac assist devices (CAD) usually suffer from end-stage acute or chronic heart failure. Since the introduction of CAD in 1963 by DeBakey and coworkers, the systems have gone through a substantial evolution and have been increasingly used in the intervening decades. The spectrum of CAD includes a variety of systems serving to assist the systolic function of the left ventricle, the right ventricle, or both. Conventional radiography and multislice spiral computed tomography (CT) are the most commonly used radiological techniques for imaging patients with a CAD. CT is very useful for evaluating CAD systems by using both two- and three-dimensional reconstructions of the volumetric data sets. The two techniques together allow for the comprehensive assessment of patients with devices by imaging the in- and outflow cannulae, the anastomoses, the position of the pump, as well as associated complications. A close collaboration with cardiac surgeons with expertise in the field of circulatory support is deemed necessary for adequate image interpretation. This article describes the technical diversity of the currently available CAD systems. The imaging characteristics on conventional radiography and multislice spiral CT as well as the typical complications of their use are demonstrated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Mendez GF, Cowie MR (2001) The epidemiological features of heart failure in developing countries: a review of the literature. Int J Cardiol 80:213–219

    Article  PubMed  CAS  Google Scholar 

  2. Hunt SA, Baker DW, Chin MH et al (2002) ACC/AHA guidelines for the evaluation and management of chronic heart failure in the adult: executive summary. J Heart Lung Transplant 21:189–203

    Article  PubMed  Google Scholar 

  3. Hetzer R, Jurmann MJ, Potapov EV et al (2002) Heart assist systems—current status. Herz 27:407–417

    Article  PubMed  Google Scholar 

  4. Gray NA Jr, Selzman CH (2006) Current status of the total artificial heart. Am Heart J 152:4–10

    Article  PubMed  Google Scholar 

  5. Hall CW, Liotta D, Henly WS, Crawford ES, Debakery ME (1964) Development of artificial intrathoracic circulatory pumps. Am J Surg 108:685–692

    Article  PubMed  CAS  Google Scholar 

  6. Frazier OH, Rose EA, Oz MC et al (2001) Multicenter clinical evaluation of the HeartMate vented electric left ventricular assist system in patients awaiting heart transplantation. J Thorac Cardiovasc Surg 122:1186–1195

    Article  PubMed  CAS  Google Scholar 

  7. DeBakey ME (1971) Left ventricular bypass pump for cardiac assistance. Clinical experience. Am J Cardiol 27:3–11

    Article  PubMed  CAS  Google Scholar 

  8. Drews T, Loebe M, Jurmann M, zu Dohna R, Erben M, Hetzer R (2001) Outpatients on biventricular assist devices. Thorac Cardiovasc Surg 49:296–299

    Article  PubMed  CAS  Google Scholar 

  9. Frazier OH, Jacob LP (2007) Small pumps for ventricular assistance: progress in mechanical circulatory support. Cardiol Clin 25:553–564, vi

    Article  PubMed  CAS  Google Scholar 

  10. Frazier OH, Delgado RM (2003) Mechanical circulatory support for advanced heart failure: where does it stand in 2003? Circulation 108:3064–3068

    Article  PubMed  CAS  Google Scholar 

  11. Jain VR, White CS, Pierson RN 3rd, Griffith BP, Sorensen EN (2005) Imaging of left ventricular assist devices. J Thorac Imaging 20:32–40

    Article  PubMed  Google Scholar 

  12. Stone ME (2007) Current status of mechanical circulatory assistance. Semin Cardiothorac Vasc Anesth 11:185–204

    Article  PubMed  Google Scholar 

  13. Cascade PN, Meaney JF, Jamadar DA (1997) Methods of cardiopulmonary support: a review for radiologists. Radiographics 17:1141–1155

    PubMed  CAS  Google Scholar 

  14. Lietz K, Miller LW (2004) Left ventricular assist devices: evolving devices and indications for use in ischemic heart disease. Curr Opin Cardiol 19:613–618

    Article  PubMed  Google Scholar 

  15. Song X, Throckmorton AL, Untaroiu A et al (2003) Axial flow blood pumps. Asaio J 49:355–364

    Article  PubMed  Google Scholar 

  16. Yacoub MH, Miller LW (2008) Long-term left-ventricular-assist-device therapy is here to stay. Nat Clin Pract Cardiovasc Med 5:60–61

    Article  PubMed  Google Scholar 

  17. Helman DN, Addonizio LJ, Morales DL et al (2000) Implantable left ventricular assist devices can successfully bridge adolescent patients to transplant. J Heart Lung Transplant 19:121–126

    Article  PubMed  CAS  Google Scholar 

  18. Birks EJ, Tansley PD, Yacoub MH et al (2004) Incidence and clinical management of life-threatening left ventricular assist device failure. J Heart Lung Transplant 23:964–969

    Article  PubMed  CAS  Google Scholar 

  19. Allen GS, Murray KD, Olsen DB (1997) The importance of pulsatile and nonpulsatile flow in the design of blood pumps. Artif Organs 21:922–928

    Article  PubMed  CAS  Google Scholar 

  20. Schmid C, Jurmann M, Birnbaum D et al (2008) Influence of inflow cannula length in axial-flow pumps on neurologic adverse event rate: results from a multi-center analysis. J Heart Lung Transplant 27:253–260

    Article  PubMed  Google Scholar 

  21. Wilhelm MJ, Hammel D, Schmid C et al (2005) Long-term support of 9 patients with the DeBakey VAD for more than 200 days. J Thorac Cardiovasc Surg 130:1122–1129

    Article  PubMed  Google Scholar 

  22. Cooper DS, Jacobs JP, Moore L et al (2007) Cardiac extracorporeal life support: state of the art in 2007. Cardiol Young 17(Suppl 2):104–115

    PubMed  Google Scholar 

  23. Gandhi SK (2009) Ventricular assist device in children. Prog Pediatr cardiol 26:11–99

    Article  Google Scholar 

  24. Aaronson KD, Patel H, Pagani FD (2003) Patient selection for left ventricular assist device therapy. Ann Thorac Surg 75:S29–S35

    Article  PubMed  Google Scholar 

  25. Bean MJ, Pannu H, Fishman EK (2005) Three-dimensional computed tomographic imaging of complex congenital cardiovascular abnormalities. J Comput Assist Tomogr 29:721–724

    Article  PubMed  Google Scholar 

  26. Leschka S, Oechslin E, Husmann L et al (2007) Pre- and postoperative evaluation of congenital heart disease in children and adults with 64-section CT. Radiographics 27:829–846

    Article  PubMed  Google Scholar 

  27. Knisely BL, Collins J, Jahania SA, Kuhlman JE (1997) Imaging of ventricular assist devices and their complications. AJR Am J Roentgenol 169:385–391

    PubMed  CAS  Google Scholar 

  28. Knollmann FD, Loebe M, Weng Y et al (1999) Radiologic anatomy of ventricular assist devices. J Thorac Imaging 14:293–299

    Article  PubMed  CAS  Google Scholar 

  29. Knollman FD, Halfmann R, Regn J et al (1999) Motion artifacts in cardiac CT. The Novacor left ventricular assist device and its implications for clinical imaging. Acta Radiol 40:569–577

    Article  PubMed  CAS  Google Scholar 

  30. Kavarana MN, Pessin-Minsley MS, Urtecho J et al (2002) Right ventricular dysfunction and organ failure in left ventricular assist device recipients: a continuing problem. Ann Thorac Surg 73:745–750

    Article  PubMed  Google Scholar 

  31. Lazar RM, Shapiro PA, Jaski BE et al (2004) Neurological events during long-term mechanical circulatory support for heart failure: the Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (REMATCH) experience. Circulation 109:2423–2427

    Article  PubMed  Google Scholar 

  32. Rose EA, Gelijns AC, Moskowitz AJ et al (2001) Long-term mechanical left ventricular assistance for end-stage heart failure. N Engl J Med 345:1435–1443

    Article  PubMed  CAS  Google Scholar 

  33. Tsukui H, Teuteberg JJ, Murali S et al (2005) Biventricular assist device utilization for patients with morbid congestive heart failure: a justifiable strategy. Circulation 112:I65–I72

    PubMed  Google Scholar 

  34. Piccione W Jr (2000) Left ventricular assist device implantation: short and long-term surgical complications. J Heart Lung Transplant 19:S89–S94

    Article  PubMed  Google Scholar 

  35. Warnecke H, Berdjis F, Hennig E et al (1991) Mechanical left ventricular support as a bridge to cardiac transplantation in childhood. Eur J Cardiothorac Surg 5:330–333

    Article  PubMed  CAS  Google Scholar 

  36. Sinha P, Chen JM, Flannery M, Scully BE, Oz MC, Edwards NM (2000) Infections during left ventricular assist device support do not affect posttransplant outcomes. Circulation 102:III194–III199

    PubMed  CAS  Google Scholar 

Download references

Acknowledgements

This research has been supported by the National Center of Competence in Research, Computer Aided and Image Guided Medical Interventions (NCCR CO-ME) of the Swiss National Science Foundation.

Author information

Authors and Affiliations

  1. Institute of Diagnostic Radiology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland

    Hans Scheffel, Paul Stolzmann, Lotus Desbiolles, Sebastian Leschka, Thomas Frauenfelder, Thomas Schertler, Borut Marincek & Hatem Alkadhi

  2. Clinic for Cardiovascular Surgery, University Hospital Zurich, Zurich, Switzerland

    Markus J. Wilhelm & Mario Lachat

Authors
  1. Hans Scheffel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Paul Stolzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Markus J. Wilhelm
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mario Lachat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lotus Desbiolles
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Sebastian Leschka
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Thomas Frauenfelder
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Thomas Schertler
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Borut Marincek
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hatem Alkadhi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hatem Alkadhi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Scheffel, H., Stolzmann, P., Wilhelm, M.J. et al. Conventional radiography and computed tomography of cardiac assist devices. Eur Radiol 19, 2097–2106 (2009). https://doi.org/10.1007/s00330-009-1406-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-009-1406-6

Keywords

Search

Navigation