Impact of echo contrast agents on ventricular assist devices (vad) hemodynamics: Are they safe to use?
Kassier A, Tawney A, Nona P, Ananthasubramaniam K. Impact of echo contrast agents on ventricular assist devices (vad) hemodynamics: Are they safe to use? J Am Coll Cardiol. Mar 2017;69(11):1632-1632.
J Am Coll Cardiol
Background: Ventricular assist devices (VADs) areapproved therapy in advanced heart failure population as a bridge to transplant or destination therapy. Echocardiography plays a crucial role in evaluation of VAD function. Echo contrast (EC) agentsare commonly used adjuncts for better visualization of cardiac chambers. The safety of EC use and their affect on VAD hemodynamics has not been well studied to our knowledge. Methods: Retrospective review of 130 patients with VAD who were hospitalized at our institution between 2010-2015. Changes in vital signs, speed, power, pulsatility index (PI) and flow were recorded within 24 hours and also 24-48 hours after EC use. Baseline characteristics, alarms, death, new arrhythmias or worsening heart failure were also recorded. Results: Our sample patients had 99 Heart Mate II, 26 Heart Ware and 5 Heart Mate III. Median age was 57 + 12.6 and median amount of contrast used was 1.5 + 0.7. There was no statistically significant changes in hemodynamics or VAD interrogation within 24 hours of contrast use. 24-48 hours post contrast was only statistically significant for changes in VAD speed. Results aredescribed in table 1. No significant new arrhythmias or worsening heart failure noted Conclusions: EC use has no adverse hemodynamic influence on VADhemodynamics. The mean change in VAD speed was likely related to changes in patient medical condition that is not related to worsening heart failure or new arrhythmias. EC use should follow standard echoindications in VAD patients (Table Presented).