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Typical but uncommon computed tomography angiographic appearance of left ventricular assist device: Awareness is key
Journal article   Open access   Peer reviewed

Typical but uncommon computed tomography angiographic appearance of left ventricular assist device: Awareness is key

Sarv Priya, Pankaj Watal, Michelle Staron and Shawn Sato
European journal of radiology Open, Vol.6, pp.132-135
2019
DOI: 10.1016/j.ejro.2019.03.004
PMCID: PMC6447749
PMID: 30989090
url
https://doi.org/10.1016/j.ejro.2019.03.004View
Published (Version of record) Open Access

Abstract

•Understanding normal imaging appearance of left ventricular assist devices is essential to avoid misinterpretation.•Dual-energy CT with reconstructed virtual unenhanced images may avoid mislabeling the postsurgical materials as calcification or hemorrhage.•Three-dimensional reconstructions may help in better understanding of the anatomy of outflow cannula. Left ventricular assist devices (LVAD) are now a standard of care for patients awaiting heart transplant. Our patient had undergone placement of the HeartWare LVAD and presented to the hospital with complaints of fatigue, dyspnea, fever and discharge from the LVAD site. She underwent computed tomography angiography (CTA) to evaluate the LVAD. CTA revealed a hypodense area surrounding the outflow graft throughout its extent. This was suspicious of a thrombus. The repeat CTA performed 4 days later did not show any change in appearance of the outflow graft. This appearance was in fact due to the co-axial relationship of the two outflow grafts creating a potential space between them that can be filled with blood. This is a normal appearance and should not be mistaken for a thrombus. The awareness of the normal imaging appearance of the LVAD devices is essential to avoid unnecessary surgical intervention.
 CTA Dual-energy CTA Left ventricular assist device LVAD thrombus

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