The growing population of heart failure patients and the corresponding increase in demand for donor hearts has led to the need of alternate medical therapies. The availability of donor hearts is scarce, transplant is expensive, and many patients are too ill to withstand the transplant operation. Left ventricular assist devices (LVADs) have aided in the treatment leading up to heart transplantation and the recovery of reversible myocardial damage. With the increasing use of LVADs, echocardiography has become an extensive diagnostic aid in the evaluation of patients with LVADs. Because of this growing use of LVADs, it is necessary for sonographers to have a complete and current awareness of these devices. This literature review aims to expand the echocardiographer's knowledge of LVADs and to offer suggestions and techniques that may help in the evaluation of a patient with an LVAD.
Harper AM, Rosendale JD: The UNOS OPTN waiting list and donor registry: 1988-1996, in Cecka JM, Terasaki PI (eds): Clinical Transplants. Los Angeles, CA, UCLA Tissue Typing Laboratory, 1996:69–90.
2.
Goldstein DJ, Oz M, Rose EA: Implantable left ventricular assist devices. N Engl J Med1998;339:1522–1533.
3.
Mancini D, Oz M, Beniaminovitz A: Current experience with left ventricular assist devices in patients with congestive heart failure. Curr Cardiol Rep. 1999;1(1):33–37.
4.
Slater JP, Rose EA, Levin HR, et al: Low thromboembolic risk without anticoagulation using advanced-design left ventricular assist devices. Ann Thorac Surg1996;62:1321– 1327.
5.
Oz M, Goldstein DJ, Rose EA: Preperitoneal placement of ventricular assist devices: an illustrated stepwise approach. J Cardio Surg1995;10:288–294.
6.
Scalia GM, McCarthy PM, Savage RM, Smedira NG, Thomas JD: Clinical utility of echocardiography in the management of implantable ventricular assist devices. JAm Soc Echocardiogr2000;13:754–763.
7.
Kececioglu D, Galal O, Halees Z, Fadely R, Wilson N, Vogt J: Transesophageal echocardiography in children with cardiac assist. Thorac Cardiovasc Surg1995;42:21–24.
Brack M, Olson JD, Pedersen WR, et al: Transesophageal echocardiography in patients with mechanical circulatory assistance. Ann Thorac Surg1991;52:1306–1309.
10.
Simon P, Owen AN, Moritz A, et al: Transesophageal echocardiography evaluation in mechanically assisted circulation. Eur J Cardiothorac Surg1991;5:492–498.
11.
Akosah KO, Song A, Guerraty A, Mohanty P, Paulsen W: Echocardiographic evaluation of patients with a left ventricular assist device. Am Soc Artif Internal Organs1998;44:M524–M527.
12.
George SJ, Black JM, Boscoe MJ: Intraoperative transesophageal echocardiography for implantation of a pulsatile left ventricular assist device. Br J Anaesthesiol1995;75:794–797.
13.
Orihashi K, Hong YW, Chung G, et al: New applications of two-dimensional transesophageal echocardiography in cardiac surgery. J Cardiothorac Vasc Anesthesiol1991;5:33– 39.
14.
Faggian G, Dan M, Bortolott U, et al: Implantation of an external biventricular device. J Heart Transplantation1990;9:441–443.
15.
Pollock SG, Dent JM, Kaul S, Lake C: Diagnosis of ventricular assist device malfunction by transesophageal echocardiography. Am Heart J1992;124:793–794.
16.
Hauptman PJ, Body S, Fow J, Couper GS, Loh E: Implantation of a pulsatile external left ventricular assist device: role of intraoperative transesophageal echocardiography. J Cardiothorac Vasc Anesthesiol1994;8:340–341.
17.
Buckland MR, Bergin P, Esmore D: Transesophageal echocardiography aids insertion and management of the “Thoratec” ventricular assist device. Anaesthesiol Intensive Care1993;21:346–349.
18.
McCarthy PM, Nakatani S, Vargo R, et al: Structural and left ventricular histologic changes after implantable LVAD insertion. Ann Thorac Surg1995;59:609–613.
19.
Nakatani S, McCarthy PM, Kottke-Marchant K, et al: Left ventricular echocardiographic and histologic changes: impact of chronic unloading by an implantable ventricular assist device. J Am Coll Cardiol1996;27:894–901.
20.
Nakatani S, Thomas JD, Vandervoort PM, et al: Left ventricular diastolic filling with an implantable ventricular assist device: beat to beat variability with overall improvement. J Am Coll Cardiol1997;30:1288–1294.
21.
Ohno M, Cheng CP, Little WC: Mechanism of altered patterns of left ventricular filling during the development of congestive heart failure. Circulation1992;89:2241–2250.
