Current Cardiology Reports

, 16:468

The Practical Role of Echocardiography in Selection, Implantation, and Management of Patients Requiring LVAD Therapy

  • Maria Chiara Todaro
  • Bijoy K. Khandheria
  • Timothy E. Paterick
  • Matt M. Umland
  • Vinay Thohan
Echocardiography (RM Lang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Echocardiography

Abstract

Viable treatment options for advanced heart failure have not emerged as the number of people afflicted with this condition has grown. Although heart transplantation is the only curative strategy for patients with end-stage heart failure, the relative shortage of donors has led to a worldwide plateau of this option over the past 20 years. The result is an unacceptably high mortality rate among patients with advanced heart failure. Interest in developing alternative curative strategies based on chronic circulatory support, with the aim of prolonging and improving quality of life for these patients, has grown. Patients supported with left ventricular assist devices require structured longitudinal care from a team of providers. An integrated approach using basic echocardiography is critical to patient selection, implantation, and continued surveillance and success of patients with left ventricular assist devices.

Keywords

Left ventricular assist device Heart failure Doppler echocardiography Right ventricular failure 

Supplementary material

11886_2014_468_MOESM1_ESM.asf (1.1 mb)
Movie 1Color Doppler parasternal long-axis view at 9,400 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are too high: left ventricle (LV) completely decompressed, interventricular septum shifted toward the LV, aortic valve not opening, flow acceleration mid-LV cavity, and no or trace mitral regurgitation. (ASF 1141 kb)
11886_2014_468_MOESM2_ESM.asf (919 kb)
Movie 2Color Doppler apical 4-chamber view at 9,400 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are too high: left ventricle (LV) completely decompressed, interventricular septum shifted toward the LV, aortic valve not opening, flow acceleration mid-LV cavity, and no or trace mitral regurgitation. (ASF 919 kb)
11886_2014_468_MOESM3_ESM.asf (613 kb)
Movie 3Color Doppler parasternal long-axis view at 9,200 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are adequately supported: left ventricle (LV) decompressed, interventricular septum shifts intermittently toward the LV, aortic valve periodically opening, no flow acceleration mid-LV cavity, and mild mitral regurgitation. (ASF 612 kb)
11886_2014_468_MOESM4_ESM.asf (575 kb)
Movie 4Color Doppler apical 4-chamber view at 9,200 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are adequately supported: left ventricle (LV) decompressed, interventricular septum shifts intermittently toward the LV, aortic valve periodically opening, no flow acceleration mid-LV cavity, and mild mitral regurgitation. (ASF 575 kb)
11886_2014_468_MOESM5_ESM.asf (957 kb)
Movie 5Color Doppler parasternal long-axis view at 8,600 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are too low: left ventricle (LV) not decompressed, interventricular septum shifts toward the right ventricle, aortic valve periodically opening, no flow acceleration mid-LV cavity, and worsening mitral regurgitation. (ASF 956 kb)
11886_2014_468_MOESM6_ESM.asf (847 kb)
Movie 6Color Doppler apical 4-chamber view at 8,600 rpm of a left ventricular assist device-supported patient demonstrating features of pump speeds that are too low: left ventricle (LV) not decompressed, interventricular septum shifts toward the right ventricle, aortic valve periodically opening, no flow acceleration mid-LV cavity, and worsening mitral regurgitation. (ASF 847 kb)

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. 1.
    Roger VL. Epidemiology of heart failure. Circ Res. 2013;113:646–59.PubMedCrossRefGoogle Scholar
  2. 2.
    Mahmood SS, Wang TJ. The epidemiology of congestive heart failure: the Framingham Heart Study perspective. Glob Heart. 2013;8:77–82.PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Stehlik J, Edwards LB, Kucheryavaya AY, et al. The Registry of the International Society for Heart and Lung Transplantation: twenty-seventh official adult heart transplant report—2010. J Heart Lung Transplant. 2010;29:1089–103.PubMedCrossRefGoogle Scholar
  4. 4.
    Rose EA, Gelijns AC, Moskowitz AJ, et al. Long-term use of a left ventricular assist device for end-stage heart failure. N Engl J Med. 2001;345:1435–43.PubMedCrossRefGoogle Scholar
  5. 5.
    Miller LW, Pagani FD, Russell SD, et al. Use of a continuous-flow device in patients awaiting heart transplantation. N Engl J Med. 2007;357:885–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Lietz K, Long JW, Kfoury AG, et al. Outcomes of left ventricular assist device implantation as destination therapy in the post-REMATCH era: implications for patient selection. Circulation. 2007;116:497–505.PubMedCrossRefGoogle Scholar
  7. 7.••
    Kirklin JK, Naftel DC, Kormos RL, et al. Fifth INTERMACS annual report: risk factor analysis from more than 6000 mechanical circulatory support patients. J Heart Lung Transplant. 2013;32(2):141–56. It summarizes and analyzes the prognosis of more than 6,000 LVAD patients implanted during the first 6 years. It is the most realistic and complete update regarding morbidity and mortality of these patients available in literature. Google Scholar
  8. 8.
    Lund LH, Matthews J, Aaronson K. Patient selection for left ventricular assist devices. Eur J Heart Fail. 2010;12:434–43.PubMedCrossRefGoogle Scholar
  9. 9.
    Slaughter MS, Meyer AL, Birks EJ. Destination therapy with left ventricular assist devices: patient selection and outcomes. Curr Opin Cardiol. 2011;26:232–6.PubMedCrossRefGoogle Scholar
  10. 10.
    Cowger J, Sundareswaran K, Rogers JG, et al. Predicting survival in patients receiving continuous flow left ventricular assist devices: the HeartMate II risk score. J Am Coll Cardiol. 2013;61:313–21.PubMedCrossRefGoogle Scholar
  11. 11.
    Lietz K. Destination therapy: patient selection and current outcomes. J Card Surg. 2010;25:462–71.PubMedCrossRefGoogle Scholar
  12. 12.
    Liden H, Karason K, Bergh CH, et al. The feasibility of left ventricular mechanical support as a bridge to cardiac recovery. Eur J Heart Fail. 2007;9:525–30.PubMedCrossRefGoogle Scholar
  13. 13.
    Rodriguez LE, Suarez EE, Loebe M, et al. Ventricular assist devices (VAD) therapy: new technology, new hope? Methodist Debakey Cardiovasc J. 2013;9:32–7.PubMedCentralPubMedGoogle Scholar
  14. 14.
    Felix SE, Martina JR, Kirkels JH, et al. Continuous-flow left ventricular assist device support in patients with advanced heart failure: points of interest for the daily management. Eur J Heart Fail. 2012;14:351–6.PubMedCrossRefGoogle Scholar
  15. 15.
    McMurray JJ, Adamopoulos S, Anker SD, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: the Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 2012;33:1787–847.Erratum in. Eur Heart J. 2013;34:158.CrossRefGoogle Scholar
  16. 16.
    American College of Cardiology Foundation Appropriate Use Criteria Task Force; American Society of Echocardiography; American Heart Association; et al. ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the American College of Chest Physicians. J Am Coll Cardiol. 2011;57:1126–66.Google Scholar
  17. 17.
    Gellen B, Canoui-Poitrine F, Lesault PF, et al. Usefulness of tissue Doppler imaging for assessing left ventricular filling pressure in patients with stable severe systolic heart failure. Am J Cardiol. 2013;112:1619–24.PubMedCrossRefGoogle Scholar
  18. 18.
    Mornoş C, Petrescu L, Ionac A, et al. The prognostic value of a new tissue Doppler parameter in patients with heart failure. Int J Cardiovasc Imaging. [Epub ahead of print: Sept 17, 2013].Google Scholar
  19. 19.
    O'Connor CM, Whellan DJ, Wojdyla D, et al. Factors related to morbidity and mortality in patients with chronic heart failure with systolic dysfunction: the HF-ACTION predictive risk score model. Circ Heart Fail. 2012;5:63–71.PubMedCentralPubMedCrossRefGoogle Scholar
  20. 20.
    Barlera S, Tavazzi L, Franzosi MG, et al. Predictors of mortality in 6975 patients with chronic heart failure in the Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico-Heart Failure trial: proposal for a nomogram. Circ Heart Fail. 2013;6:31–9.PubMedCrossRefGoogle Scholar
  21. 21.
    Senni M, Parrella P, De Maria R, et al. Predicting heart failure outcome from cardiac and comorbid conditions: the 3C-HF score. Int J Cardiol. 2013;163:206–11.PubMedCrossRefGoogle Scholar
  22. 22.
    Thohan V. Prognostic implications of echocardiography in advanced heart failure. Curr Opin Cardiol. 2004;19:238–49.PubMedCrossRefGoogle Scholar
  23. 23.
    Ciampi Q, Villari B. Role of echocardiography in diagnosis and risk stratification in heart failure with left ventricular systolic dysfunction. Cardiovasc Ultrasound. 2007;5:34.PubMedCentralPubMedCrossRefGoogle Scholar
  24. 24.
    Oh JK. Echocardiography in heart failure: beyond diagnosis. Eur J Echocardiogr. 2007;8:4–14.PubMedCrossRefGoogle Scholar
  25. 25.
    Kirkpatrick JN, Vannan MA, Narula J, et al. Echocardiography in heart failure: applications, utility, and new horizons. J Am Coll Cardiol. 2007;50:381–96.PubMedCrossRefGoogle Scholar
  26. 26.••
    Carluccio E, Dini FL, Biagioli P, et al. The 'Echo Heart Failure Score': an echocardiographic risk prediction score of mortality in systolic heart failure. Eur J Heart Fail. 2013;15:868–76. In this study, a good prognostic stratification of heart failure is performed through simple but effective clinical and echocardiographic parameters, which are easy to apply in the every-day assessment of patients. Google Scholar
  27. 27.
    Cintron G, Johnson G, Francis G, et al. Prognostic significance of serial changes in left ventricular ejection fraction in patients with congestive heart failure. The V-HeFT VA Cooperative Studies Group. Circulation. 1993;87(6 Suppl):VI17–23.PubMedGoogle Scholar
  28. 28.
    Wong M, Germanson T, Taylor WR, et al. Felodipine improves left ventricular emptying in patients with chronic heart failure: V-HeFT III echocardiographic substudy of multicenter reproducibility and detecting functional change. J Card Fail. 2000;6:19–28.PubMedCrossRefGoogle Scholar
  29. 29.
    Ghio S, Temporelli PL, Marsan NA, et al. Prognostic implications of left ventricular dilation in patients with nonischemic heart failure: interactions with restrictive filling pattern and mitral regurgitation. Congest Heart Fail. 2012;18:198–204.PubMedCrossRefGoogle Scholar
  30. 30.
    Vanoverschelde JL, Raphael DA, Robert AR, et al. Left ventricular filling in dilated cardiomyopathy: relation to functional class and hemodynamics. J Am Coll Cardiol. 1990;15:1288–95.PubMedCrossRefGoogle Scholar
  31. 31.
    Yamamoto T, Oki T, Yamada H, et al. Prognostic value of the atrial systolic mitral annular motion velocity in patients with left ventricular systolic dysfunction. J Am Soc Echocardiogr. 2003;16:333–9.PubMedCrossRefGoogle Scholar
  32. 32.
    Pinamonti B, Zecchin M, Di Lenarda A, et al. Persistence of restrictive left ventricular filling pattern in dilated cardiomyopathy: an ominous prognostic sign. J Am Coll Cardiol. 1997;29:604–12.PubMedCrossRefGoogle Scholar
  33. 33.
    Cameli M, Righini FM, Lisi M, et al. Comparison of right vs left ventricular strain analysis as a predictor of outcome in patients with systolic heart failure referred for heart transplantation. Am J Cardiol. 2013;112:1778–84.PubMedCrossRefGoogle Scholar
  34. 34.
    Damy T, Kallvikbacka-Bennett A, Goode K, et al. Prevalence of, associations with, and prognostic value of tricuspid annular plane systolic excursion (TAPSE) among out-patients referred for the evaluation of heart failure. J Card Fail. 2012;18:216–25.PubMedCrossRefGoogle Scholar
  35. 35.
    Frea S, Bovolo V, Bergerone S, et al. Echocardiographic evaluation of right ventricular stroke work index in advanced heart failure: a new index? J Card Fail. 2012;18:886–93.PubMedCrossRefGoogle Scholar
  36. 36.
    Marzec LN, Ambardekar AV. Preoperative evaluation and perioperative management of right ventricular failure after left ventricular assist device implantation. Semin Cardiothorac Vasc Anesth. 2013;17:249–61.PubMedCrossRefGoogle Scholar
  37. 37.
    Romano MA, Cowger J, Aaronson KD, et al. Diagnosis and management of right-sided heart failure in subjects supported with left ventricular assist devices. Curr Treat Options Cardiovasc Med. 2010;12:420–30.PubMedCrossRefGoogle Scholar
  38. 38.
    Meineri M, Van Rensburg AE, Vegas A. Right ventricular failure after LVAD implantation: prevention and treatment. Best Pract Res Clin Anaesthesiol. 2012;26:217–29.PubMedCrossRefGoogle Scholar
  39. 39.
    John R, Lee S, Eckman P, et al. Right ventricular failure—a continuing problem in patients with left ventricular assist device support. J Cardiovasc Transl Res. 2010;3:604–11.PubMedCrossRefGoogle Scholar
  40. 40.
    Topilsky Y, Hasin T, Oh JK, et al. Echocardiographic variables after left ventricular assist device implantation associated with adverse outcome. Circ Cardiovasc Imaging. 2011;4:648–61.PubMedCrossRefGoogle Scholar
  41. 41.••
    Topilsky Y, Oh JK, Shah DK, et al. Echocardiographic predictors of adverse outcomes after continuous left ventricular assist device implantation. JACC Cardiovasc Imaging. 2011;4:211–22. In this study, authors identify some effective echocardiographic parameters to integrate with clinical and hemodynamic data to predict right ventricular failure, which is the major cause of post-LVAD implant morbidity and mortality. Google Scholar
  42. 42.••
    Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: a report from the American Society of Echocardiography endorsed by the European Association of Echocardiography, a registered branch of the European Society of Cardiology, and the Canadian Society of Echocardiography. J Am Soc Echocardiogr. 2010;23:685–713; quiz 786–8. In this review, all the available echocardiographic parameters to study RV morphology and function are presented. This is crucial for LVAD patient selection and follow-up. Google Scholar
  43. 43.
    St John Sutton M, Pfeffer MA, Moye L, et al. Cardiovascular death and left ventricular remodeling two years after myocardial infarction: baseline predictors and impact of long-term use of captopril: information from the Survival and Ventricular Enlargement (SAVE) trial. Circulation. 1997;96:3294–9.PubMedCrossRefGoogle Scholar
  44. 44.
    Zornoff LA, Skali H, Pfeffer MA, et al. Right ventricular dysfunction and risk of heart failure and mortality after myocardial infarction. J Am Coll Cardiol. 2002;39:1450–5.PubMedCrossRefGoogle Scholar
  45. 45.
    Chumnanvej S, Wood MJ, MacGillivray TE, et al. Perioperative echocardiographic examination for ventricular assist device implantation. Anesth Analg. 2007;105:583–601.PubMedCrossRefGoogle Scholar
  46. 46.
    Raina A, Seetha Rammohan HR, Gertz ZM, et al. Postoperative right ventricular failure after left ventricular assist device placement is predicted by preoperative echocardiographic structural, hemodynamic, and functional parameters. J Card Fail. 2013;19:16–24.PubMedCrossRefGoogle Scholar
  47. 47.
    Vivo RP, Cordero-Reyes AM, Qamar U, et al. Increased right-to-left ventricle diameter ratio is a strong predictor of right ventricular failure after left ventricular assist device. J Heart Lung Transplant. 2013;32:792–9.PubMedCrossRefGoogle Scholar
  48. 48.
    Kukucka M, Stepanenko A, Potapov E, et al. Right-to-left ventricular end-diastolic diameter ratio and prediction of right ventricular failure with continuous-flow left ventricular assist devices. J Heart Lung Transplant. 2011;30:64–9.PubMedCrossRefGoogle Scholar
  49. 49.
    Kaul S, Tei C, Hopkins JM, et al. Assessment of right ventricular function using 2-dimensional echocardiography. Am Heart J. 1984;107:526–31.PubMedCrossRefGoogle Scholar
  50. 50.
    Ghio S, Recusani F, Klersy C, et al. Prognostic usefulness of the tricuspid annular plane systolic excursion in patients with congestive heart failure secondary to idiopathic or ischemic dilated cardiomyopathy. Am J Cardiol. 2000;85:837–42.PubMedCrossRefGoogle Scholar
  51. 51.
    Puwanant S, Hamilton KK, Klodell CT, et al. Tricuspid annular motion as a predictor of severe right ventricular failure after left ventricular assist device implantation. J Heart Lung Transplant. 2008;27:1102–7.PubMedCrossRefGoogle Scholar
  52. 52.•
    Ammar KA, Umland MM, Kramer C, et al. The ABCs of left ventricular assist device echocardiography: a systematic approach. Eur Heart J Cardiovasc Imaging. 2012;13:885–99. Comprehensive review on the role of echocardiography in all the phases of LVAD implant, before, during, and after the procedure. PubMedCrossRefGoogle Scholar
  53. 53.
    Meluzín J, Spinarová L, Dusek L, et al. Prognostic importance of the right ventricular function assessed by Doppler tissue imaging. Eur J Echocardiogr. 2003;4:262–71.PubMedCrossRefGoogle Scholar
  54. 54.
    Meluzin J, Spinarová L, Hude P, et al. Prognostic importance of various echocardiographic right ventricular functional parameters in patients with symptomatic heart failure. J Am Soc Echocardiogr. 2005;18:435–44.PubMedCrossRefGoogle Scholar
  55. 55.
    Meluzin J, Spinarová L, Hude P, et al. Combined right ventricular systolic and diastolic dysfunction represents a strong determinant of poor prognosis in patients with symptomatic heart failure. Int J Cardiol. 2005;105:164–73.PubMedCrossRefGoogle Scholar
  56. 56.••
    Grant AD, Smedira NG, Starling RC, et al. Independent and incremental role of quantitative right ventricular evaluation for the prediction of right ventricular failure after left ventricular assist device implantation. J Am Coll Cardiol. 2012;60:521–8. New technology, such as speckle tracking echocardiography, will have a pivotal role in patient selection, allowing a better prediction of postimplant RV performance than traditional echocardiographic parameters. This is the first large original study focused on RV free wall longitudinal strain as a predictor of prognosis in this subset of patients. PubMedCrossRefGoogle Scholar
  57. 57.
    Cameli M, Lisi M, Righini FM, et al. Speckle tracking echocardiography as a new technique to evaluate right ventricular function in patients with left ventricular assist device therapy. J Heart Lung Transplant. 2013;32:424–30.PubMedCrossRefGoogle Scholar
  58. 58.
    Abramson SV, Burke JF, Kelly Jr JJ, et al. Pulmonary hypertension predicts mortality and morbidity in patients with dilated cardiomyopathy. Ann Intern Med. 1992;116:888–95.PubMedCrossRefGoogle Scholar
  59. 59.
    Imamura T, Kinugawa K, Hatano M, et al. Bosentan improved persistent pulmonary hypertension in a case after implantation of a left ventricular assist device. J Artif Organs. 2013;16:101–4.PubMedCrossRefGoogle Scholar
  60. 60.
    Lam KM, Ennis S, O'Driscoll G, et al. Observations from noninvasive measures of right heart hemodynamics in left ventricular assist device patients. J Am Soc Echocardiogr. 2009;22:1055–62.PubMedCrossRefGoogle Scholar
  61. 61.
    Atluri P, Fairman AS, Macarthur JW, et al. Continuous flow left ventricular assist device implant significantly improves pulmonary hypertension, right ventricular contractility, and tricuspid valve competence. J Card Surg. 2013;28:770–5.PubMedCrossRefGoogle Scholar
  62. 62.
    Pauwaa S, Bhat G, Tatooles AJ, et al. How effective are continuous flow left ventricular assist devices in lowering high pulmonary artery pressures in heart transplant candidates? Cardiol J. 2012;19:153–8.PubMedCrossRefGoogle Scholar
  63. 63.
    Lanzarini L, Fontana A, Lucca E, et al. Noninvasive estimation of both systolic and diastolic pulmonary artery pressure from Doppler analysis of tricuspid regurgitant velocity spectrum in patients with chronic heart failure. Am Heart J. 2002;144:1087–94.PubMedCrossRefGoogle Scholar
  64. 64.
    Aronson D, Darawsha W, Atamna A, et al. Pulmonary hypertension, right ventricular function, and clinical outcome in acute decompensated heart failure. J Card Fail. 2013;19:665–71.PubMedCrossRefGoogle Scholar
  65. 65.
    Merlos P, Núñez J, Sanchis J, Miñana G, et al. Echocardiographic estimation of pulmonary arterial systolic pressure in acute heart failure. Prognostic implications. Eur J Intern Med. 2013;24:562–7.PubMedCrossRefGoogle Scholar
  66. 66.
    Piacentino III V, Williams ML, Depp T, et al. Impact of tricuspid valve regurgitation in patients treated with implantable left ventricular assist devices. Ann Thorac Surg. 2011;91:1342–6; discussion 1346–7.Google Scholar
  67. 67.
    Zoghbi WA, Enriquez-Sarano M, Foster E, et al. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777–802.PubMedCrossRefGoogle Scholar
  68. 68.
    Atluri P, Goldstone AB, Fairman AS, et al. Predicting right ventricular failure in the modern, continuous flow left ventricular assist device era. Ann Thorac Surg. 2013;96:857–63; discussion 863–4.Google Scholar
  69. 69.
    Baumgartner H, Hung J, Bermejo J, et al. Echocardiographic assessment of valve stenosis: EAE/ASE recommendations for clinical practice. J Am Soc Echocardiogr. 2009;22:1–23; quiz 101–2. Erratum in. J Am Soc Echocardiogr. 2009;22:442.CrossRefGoogle Scholar
  70. 70.
    Lancellotti P, Tribouilloy C, Hagendorff A, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 1: aortic and pulmonary regurgitation (native valve disease). Eur J Echocardiogr. 2010;11:223–44.PubMedCrossRefGoogle Scholar
  71. 71.
    Lancellotti P, Moura L, Pierard LA, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. 2010;11:307–32.PubMedCrossRefGoogle Scholar
  72. 72.
    Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to revise the 1998 guidelines for the management of patients with valvular heart disease). Endorsed by the Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:e1–142.PubMedCrossRefGoogle Scholar
  73. 73.
    Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC); European Association for Cardio-Thoracic Surgery (EACTS), Vahanian A, et al. Guidelines on the management of valvular heart disease (version 2012). Eur Heart J. 2012;33:2451–96.PubMedCrossRefGoogle Scholar
  74. 74.
    Pal JD, Klodell CT, John R, et al. Low operative mortality with implantation of a continuous-flow left ventricular assist device and impact of concurrent cardiac procedures. Circulation. 2009;120(11 Suppl):S215–9.PubMedCrossRefGoogle Scholar
  75. 75.
    Park SJ, Liao KK, Segurola R, et al. Management of aortic insufficiency in patients with left ventricular assist devices: a simple coaptation stitch method (Park's stitch). J Thorac Cardiovasc Surg. 2004;127:264–6.PubMedCrossRefGoogle Scholar
  76. 76.
    Dranishnikov N, Stepanenko A, Potapov EV, et al. Simultaneous aortic valve replacement in left ventricular assist device recipients: single-center experience. Int J Artif Organs. 2012;35:489–94.PubMedCrossRefGoogle Scholar
  77. 77.
    Baum C, Seiffert M, Treede H, et al. Concomitant transcatheter aortic valve and left ventricular assist device implantation. ASAIO J. 2013;59:90–2.PubMedCrossRefGoogle Scholar
  78. 78.
    Morgan JA, Tsiouris A, Nemeh HW, et al. Impact of concomitant cardiac procedures performed during implantation of long-term left ventricular assist devices. J Heart Lung Transplant. 2013;32:1255–61.PubMedCrossRefGoogle Scholar
  79. 79.
    Parikh KS, Mehrotra AK, Russo MJ, et al. Percutaneous transcatheter aortic valve closure successfully treats left ventricular assist device-associated aortic insufficiency and improves cardiac hemodynamics. JACC Cardiovasc Interv. 2013;6:84–9.PubMedCrossRefGoogle Scholar
  80. 80.
    Khan S, Koerner MM, Pae W, et al. Successful percutaneous transcatheter aortic valve replacement in multi-organ failure due to aortic bioprosthesis regurgitation in a patient with continuous-flow LVAD. J Heart Lung Transplant. 2013;32:659–63.PubMedCrossRefGoogle Scholar
  81. 81.
    Marriott K, Manins V, Forshaw A, et al. Detection of right-to-left atrial communication using agitated saline contrast imaging: experience with 1162 patients and recommendations for echocardiography. J Am Soc Echocardiogr. 2013;26:96–102.PubMedCrossRefGoogle Scholar
  82. 82.
    Shapiro GC, Leibowitz DW, Oz MC, et al. Diagnosis of patent foramen ovale with transesophageal echocardiography in a patient supported with a left ventricular assist device. J Heart Lung Transplant. 1995;14:594–7.PubMedGoogle Scholar
  83. 83.
    Bartoli CR, McCants KC, Birks EJ, et al. Percutaneous closure of a patent foramen ovale to prevent paradoxical thromboembolism in a patient with a continuous-flow LVAD. J Invasive Cardiol. 2013;25:154–6.PubMedGoogle Scholar
  84. 84.
    Loforte A, Violini R, Musumeci F. Transcatheter closure of patent foramen ovale for hypoxemia during left ventricular assist device support. J Card Surg. 2012;27:528–9.PubMedCrossRefGoogle Scholar
  85. 85.
    Estep JD, Chang SM, Bhimaraj A, et al. Imaging for ventricular function and myocardial recovery on nonpulsatile ventricular assist devices. Circulation. 2012;125:2265–77.PubMedCrossRefGoogle Scholar
  86. 86.
    Topilsky Y, Oh JK, Atchison FW, et al. Echocardiographic findings in stable outpatients with properly functioning HeartMate II left ventricular assist devices. J Am Soc Echocardiogr. 2011;24:157–69.PubMedCrossRefGoogle Scholar
  87. 87.•
    Drakos SG, Wever-Pinzon O, Selzman CH, et al. Magnitude and time course of changes induced by continuous-flow left ventricular assist device unloading in chronic heart failure: insights into cardiac recovery. J Am Coll Cardiol. 2013;61:1985–94. LVAD induces LV reverse remodeling that clinicians should be able to quantify both on a short- and long-term basis. This study analyzed all aspects of LV reverse remodeling from a structural to a molecular point of view. PubMedCrossRefGoogle Scholar
  88. 88.•
    Estep JD, Stainback RF, Little SH, et al. The role of echocardiography and other imaging modalities in patients with left ventricular assist devices. JACC Cardiovasc Imaging. 2010;3:1049–64. Comprehensive review on multimodality imaging approach to LVAD patients. Not only echocardiography, but also other imaging modalities may have a role in the selection and follow-up of these patients. PubMedCrossRefGoogle Scholar
  89. 89.
    Dang NC, Topkara VK, Mercando M, et al. Right heart failure after left ventricular assist device implantation in patients with chronic congestive heart failure. J Heart Lung Transplant. 2006;25:1–6.PubMedCrossRefGoogle Scholar
  90. 90.
    Moon MR, Bolger AF, DeAnda A, et al. Septal function during left ventricular unloading. Circulation. 1997;95:1320–7.PubMedCrossRefGoogle Scholar
  91. 91.
    Potapov EV, Stepanenko A, Dandel M, et al. Tricuspid incompetence and geometry of the right ventricle as predictors of right ventricular function after implantation of a left ventricular assist device. J Heart Lung Transplant. 2008;27:1275–81.PubMedCrossRefGoogle Scholar
  92. 92.•
    Topilsky Y, Maltais S, Oh JK, et al. Focused review on transthoracic echocardiographic assessment of patients with continuous axial left ventricular assist devices. Cardiol Res Pract. 2011;2011:187434. Practical echocardiographic approach to an LVAD carrier patient. In this study, the authors highlight what the cardiologist should know and look for to perform a good LVAD assessment..PubMedCentralPubMedGoogle Scholar
  93. 93.
    Paluszkiewicz L, Schulte-Eistrup S, Körtke H, et al. Thrombosis of the LVAD inflow cannula detected by transthoracic echocardiography: 2D and 3D thrombus visualization. Echocardiography. 2011;28:E194–5.PubMedCrossRefGoogle Scholar
  94. 94.
    May-Newman KD, Hillen BK, Sironda CS, et al. Effect of LVAD outflow conduit insertion angle on flow through the native aorta. J Med Eng Technol. 2004;28:105–9.PubMedCrossRefGoogle Scholar
  95. 95.
    Grayburn PA, Appleton CP, DeMaria AN, et al. Echocardiographic predictors of morbidity and mortality in patients with advanced heart failure: the Beta-blocker Evaluation of Survival Trial (BEST). J Am Coll Cardiol. 2005;45:1064–71.PubMedCrossRefGoogle Scholar
  96. 96.
    Dokainish H, Zoghbi WA, Lakkis NM, et al. Incremental predictive power of B-type natriuretic peptide and tissue Doppler echocardiography in the prognosis of patients with congestive heart failure. J Am Coll Cardiol. 2005;45:1223–6.PubMedCrossRefGoogle Scholar
  97. 97.
    Meta-analysis Research Group in Echocardiography (MeRGE) Heart Failure Collaborators, Doughty RN, Klein AL, et al. Independence of restrictive filling pattern and LV ejection fraction with mortality in heart failure: an individual patient meta-analysis. Eur J Heart Fail. 2008;10:786–92.Google Scholar
  98. 98.
    Somaratne JB, Whalley GA, Poppe KK, et al. Pseudonormal mitral filling is associated with similarly poor prognosis as restrictive filling in patients with heart failure and coronary heart disease: a systematic review and meta-analysis of prospective studies. J Am Soc Echocardiogr. 2009;22:494–8.PubMedCrossRefGoogle Scholar
  99. 99.
    Rossi A, Temporelli PL, Quintana M, et al. Independent relationship of left atrial size and mortality in patients with heart failure: an individual patient meta-analysis of longitudinal data (MeRGE Heart Failure). Eur J Heart Fail. 2009;11:929–36.PubMedCrossRefGoogle Scholar
  100. 100.
    Ghio S, Temporelli PL, Klersy C, et al. Prognostic relevance of a noninvasive evaluation of right ventricular function and pulmonary artery pressure in patients with chronic heart failure. Eur J Heart Fail. 2013;15:408–14.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maria Chiara Todaro
    • 2
  • Bijoy K. Khandheria
    • 1
  • Timothy E. Paterick
    • 1
  • Matt M. Umland
    • 1
  • Vinay Thohan
    • 1
  1. 1.Aurora Cardiovascular ServicesAurora Sinai/Aurora St. Luke’s Medical Centers, University of Wisconsin School of Medicine and Public HealthMilwaukeeUSA
  2. 2.Cardiology Unit, Department of Clinical and Experimental MedicineUniversity of MessinaMessinaItaly

Personalised recommendations