Multislice Spiral CT Follow-Up of a Patient With Implanted DeBakey Ventricular Assist Device
A 52-year-old patient suffering from an extensive acute myocardial infarction of the left ventricle with a residual ejection fraction of 15% developed a rapidly progressive terminal heart insufficiency with low cardiac output syndrome and severe dyspnea. To bridge the time gap until transplantation, a new type of left ventricular assist device (DeBakey VAD) was implanted. The patient could be extubated 3 hours after surgery and returned to the regular ward on postoperative day 4 after an uncomplicated recovery.
The DeBakey VAD is a small (3.5-cm diameter and 76-mm length), axial-flow blood pump with a titanium alloy for total intracorporal implantation (Figure 1⇓),1 which has already been successfully implanted in a few patients.2 Currently, our experience includes 3 patients.
To assess the correct position of the system and the cannulas and to exclude thrombotic material in the unloaded left ventricle or in the pump, a contrast-enhanced multislice spiral CT study was performed 1 week after surgery.
Parameters for the CT study were as follows: multislice spiral computed tomogram (VolumeZoom, Siemens) with a collimation of 2.5 mm and a rotation time of 0.5 seconds. During IV bolus application of an iodine contrast material (2 mL/s; 200 mg iodine/mL; 420 mg iodine/kg body wt), the study was performed during a 20-second single breath-hold. The whole heart, the thoracic aorta, and the complete system were covered. The imaging data were visualized in axial orientation and multidimensional reformatted free angulated views.
Multislice spiral CT (Figure 2⇓) clearly shows the correct position of the pump, with the inlet cannulas being centered in the middle of the left ventricle facing the aortic valve to minimize suction to the myocardium. No kinking of the outflow graft and no ventricular or system-related thrombus is visible.
Special thanks to Susanne Hess and Nino Teodorovic for image preparation.
The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.
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