Noninvasive assessment of cardiac function during ventricular assist system support using 64-row multidetector computed tomographic angiography

In patients with severe heart failure, mechanical unloading with the use of a left ventricular assist system (LVAS) has been reported to lead to myocardial recovery, which occasionally enables patients to undergo successful device removal. However, there are no conclusive data on how to predict a heart will sufficiently recover because the LVAS imposes a specific situation. The echocardiographic criteria previously proposed by another group (left ventricular [LV] diastolic dimension 45%) aid in the decision to remove the LVAS. However, because of the severe limitations of heart transplantation, we have adopted more liberal criteria and accepted LV function below these values for LVAS weaning unless the pulmonary capillary wedge pressure increases during the device halt. We think these decision processes are still immature, and we are unable to predict successful weaning. The recent advance of multidetector computed tomographic angiography (MDCTA) provides various cardiac parameters with high image quality and quantification possibilities in a single image session. The present study showed our initial experience with MDCTA as an alternative modality for accurate and informative functional analyses in patients receiving the LVAS.