PMC3890465_01
Chest X-ray after LVAD implantation. (The illustration of outflow graft is added on the patient's chest radiography)
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F1
The postoperative chest X-ray clearly shows the positions of inflow conduit, LVAD as propulsion pump, outflow cannula and power cable connected to extracorporeal controller (Fig. 1).
Checkpoint in echocardiographic assessment after LVAD implantation. (A, B) The axis and laminar flow of inflow conduit in modified apical-4-chamber view, (C) The position of interventricular septum (IVS) and interatrial septum (IAS), (D, E) The flow of inflow cannula in right parasternal view, and (F) IVC diameter in subcostal view.
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F2
We checked the patient's volume status and the function of LVAD with daily bed-side echocardiographic assessment (Fig. 2).
Hemodynamic change after LVAD implantation. Before the procedure, (A) Left ventricle was severely dilated, (B) IVS and IAS were deviated to right side due to increased left ventricular filling pressure, (C) IVC was dilated, (D) Functional mitral regurgitation of mild degree was observed. After LVAD implantation, (E) LV dimension and (G) IVC diameter were decreased, (F) IVS and IAS appeared in midline position, and (H) Functional MR was significantly decreased.
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F3
LV filling pressure was observed in follow-up echocardiography (Fig. 3). LV dimension and IVC diameter were decreased, and IVS and IAS lay in midline position instead of deviating to the right side due to increased LV filling pressure, and functional MR was significantly decreased.