Skip to main content
SpringerLink
Log in

Devices and Implants

  • Chapter
  • First Online:
Atlas of Cardiovascular Computed Tomography

  • 1163 Accesses

Abstract

Devices and implants are encountered daily by cardiac imagers. Knowledge of the expected normal appearance and function of each device facilitates detection of complications. Devices are usually seen on CT images, but their true three-dimensional appearance, course, and function may not be apparent because of beam hardening and streak artifacts. Review of the scout image or a recent chest radiograph is helpful in identifying the device and its function prior to interrogating the CT dataset. This chapter reviews the normal appearance of common and uncommon devices and implants seen on cardiac CT, including cardiac valves, pacemakers, implantable cardioverter defibrillators (ICDs), occlusion devices, and circulatory assist devices. Radiographs, scout images, volume-rendered images, and illustrations are used for correlation when possible. The chapter also reviews the role of CT in procedural planning for the LARIAT procedure and for insertion of percutaneous heart valves and left atrial appendage occluder devices. Device-specific complications are also reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Habets J, Mali WP, Budde RP. Multidetector CT angiography in evaluation of prosthetic heart valve dysfunction. Radiographics. 2012;32:1893–905.

    Article  PubMed  Google Scholar 

  2. Leipsic J, Wood D, Manders D, Nietlispach F, Masson JB, Mayo J, et al. The evolving role of MDCT in transcatheter aortic valve replacement: a radiologists’ perspective. Am J Roentgenol. 2009;193:W214–9.

    Article  Google Scholar 

  3. Holmes DR Jr, Mack MJ, Kaul S, Agnihotri A, Alexander KP, Bailey SR, et al. 2012 ACCF/AATS/SCAI/STS expert consensus document on transcatheter aortic valve replacement. J Am Coll Cardiol. 2012;59:1200–54.

    Article  PubMed  Google Scholar 

  4. Pham N, Zaitoun H, Mohammed TL, DeLaPena-Almaguer E, Martinez F, Novaro GM, Kirsch J. Complications of aortic valve surgery: manifestations at CT and MR imaging. Radiographics. 2012;32:1873–92.

    Article  PubMed  Google Scholar 

  5. Teshima H, Hayashida N, Fukunaga S, Tayama E, Kawara T, Aoyagi S, Uchida M. Usefulness of a multidetector-row computed tomography scanner for detecting pannus formation. Ann Thorac Surg. 2004;77:523–6.

    Article  PubMed  Google Scholar 

  6. O'Rourke DJ, Palac RT, Malenka DJ, Marrin CA, Arbuckle BE, Plehn JF. Outcome of mild periprosthetic regurgitation detected by intraoperative transesophageal echocardiography. J Am Coll Cardiol. 2001;38:163–6.

    Article  CAS  PubMed  Google Scholar 

  7. Jindani A, Neville EM, Venn G, Williams BT. Paraprosthetic leak: a complication of cardiac valve replacement. J Cardiovasc Surg (Torino). 1991;32:503–8.

    CAS  Google Scholar 

  8. Rizzoli G, Russo R, Valente S, Mazzucco A, Valfre C, Brumana T, et al. Dehiscence of aortic valve prostheses: analysis of a ten-year experience. Int J Cardiol. 1984;6:207–21.

    Article  CAS  PubMed  Google Scholar 

  9. Kim RJ, Weinsaft JW, Callister TQ, Min JK. Evaluation of prosthetic valve endocarditis by 64-row multidetector computed tomography. Int J Cardiol. 2007;120:e27–9.

    Article  PubMed  Google Scholar 

  10. Dossche KM, Tan ME, Schepens MA, Morshuis WJ, de la Rivière AB. Twenty-four year experience with reoperations after ascending aortic or aortic root replacement. Eur J Cardiothorac Surg. 1999;16:607–12.

    Article  CAS  PubMed  Google Scholar 

  11. Costelloe CM, Murphy WA, Gladish GW, Rozner MA. Radiography of pacemakers and implantable cardioverter defibrillators. Am J Roentgenol. 2012;199:1252–8.

    Article  Google Scholar 

  12. Aguilera AL, Volokhina YV, Fisher KL. Radiography of cardiac conduction devices: a comprehensive review. Radiographics. 2011;31:1669–82.

    Article  PubMed  Google Scholar 

  13. Kadish A, Mehra M. Heart failure devices: implantable cardioverter-defibrillators and biventricular pacing therapy. Circulation. 2005;111:3327–35.

    Article  PubMed  Google Scholar 

  14. Shanmugam N, Liew R. The implantable loop recorder—an important addition to the armentarium in the management of unexplained syncope. Ann Acad Med Singapore. 2012;41:115–24.

    PubMed  Google Scholar 

  15. Steiner RM, Tegtmeyer CJ, Morse D, Moses ML, Goodman LR, Nanda N, et al. The radiology of cardiac pacemakers. Radiographics. 1986;6:373–99.

    Article  CAS  PubMed  Google Scholar 

  16. Hirschl DA, Jain VR, Spindola-Franco H, Gross JN, Haramati LB. Prevalence and characterization of asymptomatic pacemaker and ICD lead perforation on CT. Pacing Clin Electrophysiol. 2007;30:28–32.

    Article  PubMed  Google Scholar 

  17. Boriani G, Biffi M, Martignani C. Uneventful right ventricular perforation with displacement of a pacing lead into the left thorax. J Cardiothorac Vasc Anesth. 2008;22:423–5.

    Article  PubMed  Google Scholar 

  18. Tobis J, Shenoda M. Percutaneous treatment of patent foramen ovale and atrial septal defects. J Am Coll Cardiol. 2012;60:1722–32.

    Article  PubMed  Google Scholar 

  19. Hundley WG, Li HF, Lange RA, Pfeifer DP, Meshack BM, Willard JE, et al. Assessment of left-to-right intracardiac shunting by velocity-encoded, phase-difference magnetic resonance imaging. A comparison with oximetric and indicator dilution techniques. Circulation. 1995;91:2955–60.

    Article  CAS  PubMed  Google Scholar 

  20. Lee T, Tsai IC, Fu YC, Jan SL, Wang CC, Chang Y, Chen MC. MDCT evaluation after closure of atrial septal defect with an Amplatzer septal occluder. Am J Roentgenol. 2007;188:W431–9.

    Article  Google Scholar 

  21. Bartus K, Han FT, Bednarek J, Myc J, Kapelak B, Sadowski J, et al. Percutaneous left atrial appendage suture ligation using the LARIAT device in patients with atrial fibrillation: initial clinical experience. J Am Coll Cardiol. 2013;62:108–18.

    Article  PubMed  Google Scholar 

  22. Wang Y, Di Biase L, Horton RP, Nguyen T, Morhanty P, Natale A. Left atrial appendage studied by computed tomography to help planning for appendage closure device placement. J Cardiovasc Electrophysiol. 2010;21:973–82.

    Article  PubMed  Google Scholar 

  23. Kimura-Hayama ET, Meléndez G, Mendizábal AL, Meave-González A, Zambrana GF, Corona-Villalobos CP. Uncommon congenital and acquired aortic diseases: role of multidetector CT angiography. Radiographics. 2010;30:79–98.

    Article  PubMed  Google Scholar 

  24. Bilkis AA, Alwi M, Hasri S, Haifa AL, Geetha K, Rehman MA, Hasanah I. The Amplatzer duct occluder: experience in 209 patients. J Am Coll Cardiol. 2001;37:258–61.

    Article  CAS  PubMed  Google Scholar 

  25. Waksman R, Weiss AT, Gotsman MS, Hasin Y. Intra-aortic balloon counterpulsation improves survival in cardiogenic shock complicating acute myocardial infarction. Eur Heart J. 1993;14:71–4.

    Article  CAS  PubMed  Google Scholar 

  26. Hurwitz LM, Goodman PC. Intraaortic balloon pump location and aortic dissection. Am J Roentgenol. 2005;184:1245–6.

    Article  Google Scholar 

  27. Agarwal PP, Cascade PN, Pagani F. Novel treatment options for chronic heart failure: a radiologist's perspective. Am J Roentgenol. 2009;193:W14–24.

    Article  Google Scholar 

  28. Mancini D, Burkhoff D. Mechanical device-based methods of managing and treating heart failure. Circulation. 2005;112:438–48.

    Article  PubMed  Google Scholar 

  29. Carr CM, Jacob J, Park SJ, Karon BL, Williamson EE, Araoz PA. CT of left ventricular assist devices. Radiographics. 2010;30:429–44.

    Article  PubMed  Google Scholar 

  30. Radovancevic B, Vrtovec B, Frazier OH. Left ventricular assist devices: an alternative to medical therapy for end-stage heart failure. Curr Opin Cardiol. 2003;18:210–4.

    Article  PubMed  Google Scholar 

  31. Fajardo LL, Standen JR, Smith RG. Radiologic appearance of the Jarvik artificial heart implant and its thoracic complications. Am J Roentgenol. 1988;151:667–71.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Radiology, Saint Luke’s Hospital of Kansas City, Kansas City, MO, USA

    Christopher M. Walker MD

  2. Department of Radiology, Weill Cornell Medicine, 525 E. 68th Street, L-024, New York, NY, 10021, USA

    Quynh A. Truong MD, MPH

  3. Department of Radiology, Division of Cardiothoracic Imaging, UT Southwestern Medical Center, 5323 Harry Hines Boulevard, E6.120A Mail Code 9316, Dallas, TX, 75390, USA

    Suhny Abbara MD

Authors
  1. Christopher M. Walker MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Quynh A. Truong MD, MPH
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Suhny Abbara MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Suhny Abbara MD .

Editor information

Editors and Affiliations

  1. Los Angeles Biomedical Research Institute, UCLA, Torrance, California, USA

    Matthew J. Budoff

  2. Department of Cardiology, Universitätsklinikum Erlangen, Erlangen, Germany

    Stephan S. Achenbach

  3. Mount Sinai Hospital, New York City, New York, USA

    Harvey S. Hecht

  4. Department of Cardiology , Mount Sinai Hospital, New York, New York, USA

    Jagat Narula

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer-Verlag London Ltd., part of Springer Nature

About this chapter

Cite this chapter

Walker, C.M., Truong, Q.A., Abbara, S. (2018). Devices and Implants. In: Budoff, M., Achenbach, S., Hecht, H., Narula, J. (eds) Atlas of Cardiovascular Computed Tomography. Springer, London. https://doi.org/10.1007/978-1-4471-7357-1_18

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-7357-1_18

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-7356-4

  • Online ISBN: 978-1-4471-7357-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation