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Expanding the Scope of Multimodality Imaging in Durable Mechanical Circulatory Support
JACC: Cardiovascular Imaging ( IF 12.8 ) Pub Date : 2020-04-01 , DOI: 10.1016/j.jcmg.2019.05.035
Zaid I Almarzooq 1 , Anubodh S Varshney 1 , Muthiah Vaduganathan 1 , Manan Pareek 2 , Garrick C Stewart 1 , Jerry D Estep 3 , Mandeep R Mehra 1
Affiliation  

An increasing number of patients transition to advanced-stage heart failure refractory to medical therapy. Left ventricular assist systems (LVAS) provide a bridge to candidates awaiting heart transplantation and extended device durability allows permanent implantation referred to as destination therapy. Noninvasive imaging plays a pivotal role in the optimal management of patients implanted with durable mechanical circulatory support (MCS) devices. Several advances require an updated perspective of multi-modality imaging in contemporary LVAS management. First, there has been substantial evolution of devices such as the introduction of the fully magnetically levitated HeartMate 3 pump (Abbott, Abbott Park, Illinois). Second, imaging beyond the device, of the peripheral system, is increasingly recognized as clinically relevant. Third, U.S. Food and Drug Administration recalls have called attention to LVAS complications beyond pump thrombosis that are amenable to imaging-based diagnosis. Fourth, there is increased availability of multimodality imaging, such as computed tomography and positron emission tomography, at many centers across the world. In this review, the authors provide a practical and contemporary approach to multi-modality imaging of current-generation durable MCS devices. As the use of LVAS and other novel MCS devices increases globally, it is critical for clinicians caring for LVAS patients to understand the roles of various imaging modalities in patient evaluation and management.

中文翻译:

扩展耐用性机械循环支持中的多模态成像范围


越来越多的患者转为难于药物治疗的晚期心力衰竭。左心室辅助系统(LVAS)为等待心脏移植的候选人提供了桥梁,并且延长的设备耐用性允许进行永久植入,称为目标疗法。无创成像在植入耐用的机械循环支持(MCS)设备的患者的最佳管理中起着关键作用。几项进展需要当代LVAS管理中多模式成像的更新视角。首先,设备发生了重大变化,例如引入了完全磁悬浮的HeartMate 3泵(伊利诺伊州阿伯特,雅培公园)。其次,越来越多的人认为外围系统的设备以外的影像具有临床意义。第三,美国 美国食品药品监督管理局召回了除基于血栓形成的泵血栓形成之外的LVAS并发症,这些并发症可用于基于影像学的诊断。第四,在世界上许多中心,多模态成像(例如计算机断层扫描和正电子发射断层扫描)的可用性越来越高。在这篇综述中,作者为当代耐用型MCS设备的多模态成像提供了一种实用的当代方法。随着LVAS和其他新型MCS设备的使用在全球范围内的增长,对于照顾LVAS患者的临床医生来说,了解各种成像方式在患者评估和管理中的作用至关重要。在世界上许多中心,多模态成像(例如计算机断层扫描和正电子发射断层扫描)的可用性越来越高。在这篇综述中,作者为当代耐用型MCS设备的多模态成像提供了一种实用的当代方法。随着LVAS和其他新型MCS设备的使用在全球范围内的增长,对于照顾LVAS患者的临床医生来说,了解各种成像方式在患者评估和管理中的作用至关重要。在世界上许多中心,多模态成像(例如计算机断层扫描和正电子发射断层扫描)的可用性越来越高。在这篇综述中,作者为当代耐用型MCS设备的多模态成像提供了一种实用的当代方法。随着LVAS和其他新型MCS设备的使用在全球范围内的增长,对于照顾LVAS患者的临床医生来说,了解各种成像方式在患者评估和管理中的作用至关重要。
更新日期:2020-04-01
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