Left ventricular assist devices (LVADs) are gaining increasing importance as therapeutic
strategy in advanced heart failure (HF), not only as bridge to recovery or to transplant
but also as destination therapy. Even though long-term LVADs are considered a precious
resource to expand the treatment options and improve clinical outcome of these patients,
these are limited by peri-operative and post-operative complications, such as device-related
infections, haemocompatibility-related events, device mis-positioning, and right ventricular
failure. For this reason, a precise pre-operative, peri-operative, and post-operative
evaluation of these patients is crucial for the selection of LVAD candidates and the
management LVAD recipients. The use of different imaging modalities offers important
information to complete the study of patients with LVADs in each phase of their assessment,
with peculiar advantages/disadvantages, ideal application, and reference parameters
for each modality. This clinical consensus statement sought to guide the use of multimodality
imaging for the evaluation of patients with advanced HF undergoing LVAD implantation.
Graphical Abstract Use of multimodality imaging for pre-operative, peri-operative,
and post-operative evaluation of patients with left ventricular assist devices. AR,
aortic regurgitation; AV, aortic valve; CT, computed tomography; CMR, cardiac magnetic
resonance; LV, left ventricular; LVAD, left ventricular assist device; PET, positron
emission tomography; PFO, patent foramen ovale; RV, right ventricular; TOE, transoesophageal
echocardiography; TR, tricuspid regurgitation; TTE, transthoracic echocardiography.
