E2229. Novel and Commonly Used Thoracic and Cardiac Life Support Apparatus: A Pictorial Review of Applications, Positioning, and Complications
  1. Ragheed Al-Dulaimi; University of Utah
  2. Jessica Chan; University of Utah
  3. Hamid Chalian; University of Utah
Cardiovascular devices and thoracic life support apparatus have increased in variety and usage significantly over the last decade. Radiologists are frequently tasked with evaluating these devices and apparatus in critically ill and postoperative patients on chest radiography or computed tomography. The purpose of this pictorial essay is to provide a comprehensive review of the application, accepted position, and commonly encountered complications of commonly used and novel devices & apparatus being used to support the cardiopulmonary system. This pictorial review is directed toward radiology residents, fellows and radiologists.

Educational Goals / Teaching Points
This exhibit is directed toward radiology residents, general and cardiothroacic radiologists. The aim of this exhibit is to review the types and applications of cardiothoracic implanted devices, and life support apparatus commonly encountered on chest radiographs and CTs, to determine how to differentiate between normal positioning versus misplacement and positioning errors and to display cases with findings associated with complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
We will discuss types, application, normal appearance, position as well as misplacement and complications of different cardiovascular and thoracic devices. We will cover tracheobronchial tubes and devices (including: endotracheal tube, tracheostomy, endobronchial valve), chest tubes, pleural catheters, tubes and devices through the esophagus (including enteric tube, PH meter, temperature meter), heart valve repair devices (including TAVR -transcatheter aortic valve replacement and valve clips), cardiac conduction devices (such as loop recorder, pacemaker, ICD - Implantable cardioverter defibrillator), mechanical circulatory devices (including: ECMO -Extracorporeal membrane oxygenation, IABP: Intra-aortic balloon pump, VAD: Ventricular assist devices), pulmonary artery pressure monitoring devices, vascular stents, Intravenous lines (including: central venous catheter, medication ports, PICC - peripherally inserted central catheter, superior vena cava filter) and intrathecal devices.

Knowledge of the purpose and normal positioning of commonly used and novel cardiovascular devices and thoracic life support apparatus is critical for radiologists in understanding and recognizing malposition and other complications.