Division of Cardiovascular Diseases, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
ASAIO J. 2011 Jan-Feb;57(1):32-7. doi: 10.1097/MAT.0b013e3181fd3405.
The purpose of this study is to describe the utility and limitations of gated contrast-enhanced cardiac computed tomography angiography in assessing left ventricular assist device function. Computed tomography angiography (CTA) was used in 14 patients with left ventricular assist devices (LVADs) who had persistent heart failure symptoms, hemodynamic instability, or potential problems with LVAD flows. Retrospectively gated contrast-enhanced CTA was performed on 64-detector scanner, and the CTA images were postprocessed in multiple curved projections on TeraRecon workstation. This study describes the use of CTA to identify LVAD-related issues that altered clinical management and explores the role of CTA and other techniques in evaluating LVAD function. Six of 14 LVAD patients who demonstrated no abnormality on CTA remained stable with medical management. In the remaining eight patients, CTA was abnormal, including abnormalities specifically related to the LVAD cannula. As a result of findings detected by CTA, six patients underwent surgical intervention, including device exchange and heart transplant. Computed tomography angiography is a noninvasive method that enhances diagnostic evaluation of patients with suspected LVAD dysfunction and can lead to changes in patient management.
本研究旨在描述门控对比增强心脏 CT 血管造影在评估左心室辅助装置功能中的作用和局限性。在 14 例持续存在心力衰竭症状、血流动力学不稳定或左心室辅助装置血流潜在问题的左心室辅助装置（LVAD）患者中使用了 CT 血管造影（CTA）。在 64 排探测器扫描仪上进行回顾性门控对比增强 CTA，然后在 TeraRecon 工作站上的多个曲面投影中对 CTA 图像进行后处理。本研究描述了 CTA 用于识别改变临床管理的 LVAD 相关问题，并探讨了 CTA 和其他技术在评估 LVAD 功能中的作用。在 CTA 未见异常的 14 例 LVAD 患者中，有 6 例经药物治疗后病情稳定。在其余 8 例患者中，CTA 异常，包括与 LVAD 套管特别相关的异常。由于 CTA 检测到的结果，6 例患者接受了手术干预，包括设备更换和心脏移植。CTA 是一种非侵入性方法，可增强对疑似 LVAD 功能障碍患者的诊断评估，并可导致患者管理的改变。
