Ventricular Assist Device : Role Of The Sonographer

-Look for most recent implant CXR or Chest CT -Review image from previous echo -Involve responsible MD sooner rather than later -After patient is roomed, confirm the battery is with patient -Find surgical note:device type -Find surgical note:anatomic placement details (position of outflow cannula insertion)
Ventricular Assist Device : TTE In VAD Patients
>> Parasternal Window
- LVIDd,LVIDs - RV size and function - LV apical inflow cannula (2D and Color Flow) - Outflow cannula (If it is in the Asc Ao, try Right Parasternal Window) - LVOT and RVOT diameter - RVOT TVI for Cardiac Output calculations - Is the Aortic Opening? - Assessment of AR, MR and TR
>> Apical/Para Apical Window
- Apical inflow cannula (2D and Color Flow) - Assessment of MR,TR and AR - RV size and function - LVOT PW TVI (if aortic valve is opening) - Pulse wave and color flow Doppler of inflow cannula - Note pericardial effusion or constructions - May need to measure diameters, assess color flow and aortic valve opening at various    flow setting
- If flow adjustments are desired, a VAD coordinator should be present to change flows or to disable device during echo study
Hit: 8 Laman Asal