Ventricular Assist Device : Role Of
The Sonographer
-Look for most recent implant CXR or Chest CT
-Review image from previous echo
-Involve responsible MD sooner rather than later
-After patient is roomed, confirm the battery is with
patient
-Find surgical note:device type
-Find surgical note:anatomic placement details
(position of outflow cannula insertion)
Ventricular Assist Device : TTE In VAD
Patients
>> Parasternal
Window
-
LVIDd,LVIDs
- RV size
and function
- LV apical
inflow cannula (2D and Color Flow)
- Outflow
cannula (If it is in the Asc Ao, try Right Parasternal Window)
- LVOT and
RVOT diameter
- RVOT TVI
for Cardiac Output calculations
- Is the
Aortic Opening?
- Assessment
of AR, MR and TR
>> Apical/Para
Apical Window
- Apical
inflow cannula (2D and Color Flow)
- Assessment
of MR,TR and AR
- RV size
and function
- LVOT PW
TVI (if aortic valve is opening)
- Pulse wave
and color flow Doppler of inflow cannula
- Note
pericardial effusion or constructions
- May need
to measure diameters, assess color flow and aortic valve opening at
various flow setting
- If flow
adjustments are desired, a VAD coordinator should be present to change flows or
to disable device during echo study
