Devices and Implants

Devices and implants are encountered daily by cardiac imagers. Knowledge of the expected normal appearance and function of each device facilitates detection of complications. Devices are usually seen on CT images, but their true three-dimensional appearance, course, and function may not be apparent because of beam hardening and streak artifacts. Review of the scout image or a recent chest radiograph is helpful in identifying the device and its function prior to interrogating the CT dataset. This chapter reviews the normal appearance of common and uncommon devices and implants seen on cardiac CT, including cardiac valves, pacemakers, implantable cardioverter defibrillators (ICDs), occlusion devices, and circulatory assist devices. Radiographs, scout images, volume-rendered images, and illustrations are used for correlation when possible. The chapter also reviews the role of CT in procedural planning for the LARIAT procedure and for insertion of percutaneous heart valves and left atrial appendage occluder devices. Device-specific complications are also reviewed.