Table 2 Imaging findings of mechanical circulatory support device complications
Complication | CXR | Echo/US | CT |
|---|---|---|---|
Malposition | Markers not at expected landmarks Change in position compared to prior imaging | Markers not at expected landmarks Change in position compared to prior imaging | Markers not at expected landmarks Change in position compared to prior imaging |
Hematoma | New mediastinal widening or pleural parenchymal opacities | Hemopericardium with/without tamponade | High attenuation fluid collection. Active contrast extravasation on contrast enhanced CT |
Cardiovascular perforation | Tip beyond the cardio mediastinal contour | Inability to dislodge the device | Tip in the mediastinum with associated hemopericardium or hemothorax |
Thrombus | – | Echogenic lesion abutting the device | Acute thrombus can be hyperdense to blood pool on non-contrast CT Chronic Thrombus can have calcifications Thrombus is hypodense to myocardium on contrast enhanced CT |
Embolus | – | Decreased/absent peripheral arterial flow | Signs of infarcts/ischemia due to distal emboli |