What Cardiac Device is That? Interactive Session on Imaging Heart Failure Patients (2024)-R7-CCA04-2024

Video Transcription

Video Summary

The video presentation covered several key topics related to imaging complexities in patients with Extracorporeal Membrane Oxygenation (ECMO) and other cardiac devices. The primary focus was on adapting CT imaging protocols to accurately diagnose and manage patients on ECMO, a modified cardiopulmonary bypass system used in severe cardiac or pulmonary failure. Two types of ECMO were discussed: Venovenous (VV), for respiratory failure, and Venoarterial (VA), for cardiac failure. Imaging challenges, such as the risk of contrast dilution due to ECMO flow and the potential dislodgement of catheters during CT scans, were highlighted.<br /><br />Several steps were outlined to improve imaging outcomes, including evaluating the clinical need for a CT, careful patient positioning, and contrast injection strategies. These steps aim to ensure diagnostic accuracy by addressing issues like timing of contrast boluses and table excursion to avoid catheter displacement.<br /><br />Furthermore, the presentation discussed the appearance, positioning, and complications of cardiac devices, such as pacemakers, ICDs, CRTs, and LVADs. Tips on identifying these devices on X-rays and CTs were provided, alongside methods to assess complications like lead dislodgement. Imaging approaches for thrombus detection, hemorrhagic complications (e.g., GI bleeding due to AVMs), and infections in LVAD patients were also discussed. Techniques like REM studies in LVADs were explained for assessing flow obstructions. Overall, the presentation emphasized methodical imaging adjustments to enhance patient care and mitigate the inherent risks associated with complex cardiac support systems.

Keywords

ECMO

CT imaging

cardiac devices

Venovenous ECMO

Venoarterial ECMO

contrast dilution

catheter displacement

pacemakers

LVAD complications

thrombus detection