ASE shares new guideline on imaging patients with implanted devices
The American Society of Echocardiography (ASE) has shared new recommendations for performing medical imaging exams on heart failure patients with surgically implanted left ventricular assist devices (LVADs) and temporary mechanical circulatory support (TMCS) devices. The guideline, published in full in the Journal of the American Society of Echocardiography, represents ASE’s first update on the topic since 2015.[1]
Much of the new recommendations are focused on the HeartMate 3 LVAD from Abbott Cardiovascular, the only device of its kind currently available in the United States. The HeartMate 3 LVAD works by pumping blood for the patient’s left ventricle, diverting it to other areas of the body. Cardiologists and cardiac surgeons often turn to these devices before or after a heart transplant. In some cases when nothing else is effective, the device is viewed as a permanent destination therapy.
“We provide detailed information and recommendations on TMCS devices, and we define the contemporary role of echocardiography and multimodality imaging in patient selection, pre-intra-and post-procedural surveillance, and troubleshooting with focus on the HeartMate 3 LVAD,” lead author Jerry Estep, MD, the division chair of cardiovascular medicine at Cleveland Clinic Florida in Weston, said in a statement. “We hope the framework we provide will improve patient outcomes by providing the best imaging strategies before and after durable and temporary device implantation.”
One of the biggest takeaways from the new document is the increased focus on point-of-care ultrasound (POCUS) as a tool that can help care teams evaluate patients. In fact the group highlights the modality’s “growing role” and points to POCUS as an effective option when treating certain TMCS patients.
The guideline also covers multiple “red flags” to watch for when considering LVAD implantation in a heart patient. Screening patients with echocardiography is the easiest way to spot these issues ahead of time, the authors explained, and CT and MRI scans “may be complementary modalities” when developing your treatment strategy.
Click here to read the full guideline.