ARRS 2022 Abstracts


E1659. Imaging of Cardiovascular Devices: Beyond the Pacer Lead
  1. Aneta Kowalski; University of Pittsburgh Medical Center
  2. Jacob Sechrist; University of Pittsburgh Medical Center
Increasing use and evolution of cardiovascular devices requires the radiologist to have a working knowledge of their radiographic characteristics, as imaging is important in the initial assessment and follow-up of such interventions.

Educational Goals / Teaching Points
This educational exhibit will review the normal and abnormal radiologic appearances of various cardiovascular devices and their components.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Cardiac conduction devices (CCDs) include pacemakers and implantable cardioverter defibrillators (ICDs), distinguishable by number, type, and size of leads and other hardware. Identifiable complications include lead malposition, fracture, and disengagement from generator. Ventricular assist devices (VADs) may be percutaneous (intra-aortic balloon pump, Impella) or surgically placed (RVAD, LVAD). These are distinguishable by cannula placement and pump configuration. Identifiable complications include malposition, thrombus, hematoma, and infection. Extracorporeal membrane oxygenation (ECMO) includes veno-venous (VV) and veno-arterial (VA) approaches. Both require proper positioning of cannulas either peripherally or centrally, and complications may include hematoma and Harlequin syndrome. Transcatheter valve therapy (Mitraclip and transcatheter pulmonary, aortic, and mitral valve replacement [TPVR, TAVR, and TMVR, respectively]) and left atrial appendage closure devices (Atriclip, Watchman, and Amplatzer plug) as well as associated device misplacement and failure will be reviewed. Cardiac monitoring devices such as implantable loop recorders and CardioMEMS have specific imaging characteristics.

Regular review of cardiovascular device appearance is important in the assessment of their proper function and possible malfunction.