title: Transthoracic echocardiography of the HeartWare left ventricular assist device.
abstract: BACKGROUND
  The unique findings on transthoracic echocardiography of the HeartWare left ventricular assist device (LVAD) have not been previously described.
  
  
  RESULTS
  HeartWare LVADs were implanted in 19 patients from May 2009 through December 2010; 152 comprehensive transthoracic echocardiograms (TTEs) performed postoperatively on these patients were retrospectively analyzed for device component visualization, inlet cannula/outflow conduit flow velocities, and imaging artifacts. The inlet cannula was adequately visualized in 66% of studies, incompletely visualized in 14%, and not visualized in 20%. Spectral Doppler interrogation of inlet cannula flow velocity was always uninterpretable due to artifact. Standard parasternal long-axis and apical views always included the inlet cannula in the imaging sector, resulting in a prominent "waterfall" color Doppler artifact obscuring the mitral valve. Inclusion of the inlet cannula in the imaging sector also precluded spectral Doppler interrogation of the mitral valve owing to artifact. The outflow conduit was partially visualized and interrogated by spectral Doppler in 68% of studies, and the average measured peak flow velocity was 1.4 m/s (range 1.0-1.9 m/s).
  
  
  CONCLUSIONS
  The HeartWare LVAD inlet cannula and outflow conduit are both readily visualized by TTE in a majority of patients. However, significant color and spectral Doppler artifacts occur when the inlet cannula is visualized in the imaging sector, necessitating routine off-axis Doppler interrogation of the mitral valve.
authors.affiliation: Texas Heart Institute, St. Luke's Episcopal Hospital, Houston, Texas, USA.
authors.forename: Nishant R
authors.initials: NR
authors.lastname: Shah
authors.forename: Cihan
authors.initials: C
authors.lastname: Cevik
authors.forename: Antonieta
authors.initials: A
authors.lastname: Hernandez
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
authors.forename: Raymond F
authors.initials: RF
authors.lastname: Stainback
mesh_terms: D004452:Echocardiography; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000628:therapy*; D006352:Heart Ventricles / Q000294:innervation*; D006353:Heart-Assist Devices; D006801:Humans; D008943:Mitral Valve / Q000473:pathology; D012189:Retrospective Studies