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Insights into Imaging
Fig. 9 | Insights into Imaging

Fig. 9

From: CT and chest radiography in evaluation of mechanical circulatory support devices for acute heart failure

Fig. 9

Complication from Impella. AP Chest radiograph with a left ventricle Impella device (a). The inlet port of the Impella is not in expected location on this radiograph, outlet port is much below the carina (white arrow) and the pigtail portion is coiled in the left ventricle cavity (white dashed arrow). The pigtail portioned is coiled, this is a sign of malposition. This can indicate entrapment within the papillary muscle apparatus. Non-contrast coronal CT at the level of the LVOT (b) confirms low positioned of the Impella device. The tip of the device has perforated the left ventricular wall (white arrow) and high density fluid can be seen in the pericardium, compatible with hemopericardium. (LVOT—Left ventricle outflow tract)

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