Radiologic anatomy of ventricular assist devices

Ventricular assist devices (VAD) allow for long-term circulatory support of patients with end-stage heart failure. With the increasing duration of cir culatory support, diagnostic imaging plays an important role in the managem ent of patients on a VAD. The aim of our review was to analyze the radiolog ic features of different VADs. From 1987 to 1996, 319 patients (mean age 42 years, range 3 to 74 years) were treated with a VAD. A Berlin Heart VAD wa s implanted in 263 of the patients, the univentricular Baxter Novacor was i mplanted in three patients, and the univentricular CI Heartmate was implant ed in 19 patients. All patients were studied by serial chest radiographs. I n addition, 70 patients underwent computed tomography (CT), and five patien ts underwent electron beam CT. The Berlin Heart VAD was used as a biventric ular support system in 218 patients. In all cases, the position of the wire -directed cannulae was identified on the chest radiographs, while the exact position of the cannula tip could be visualized by CT only. The plastic ca nnulae of both the Novacor and the Heartmate were not discernible on radiog raphs, but required CT for evaluation. Computed tomography also resolved th e metal components of the pumps. The titanium-made pump housing of the Hear tmate caused beam-hardening artefacts that might conceal fluid accumulation s in the pump pocket. Computed tomography is the standard of reference for examinations of cannula position, pump position, and pump components of ven tricular assist devices.