Left ventricular assist device and implantable cardioverter-defibrillator
Presentation
Presented with chest pain. Background of ICD and LVAD insertion secondary to decompensated heart failure.
Patient Data
A single-lead pacing device is seen in the left pectoral region, with adequate placement of the SVC coil, lead and RV coil.
The LVAD device connects the left ventricle to the aorta, and the inflow tract, pump, outflow tract and LVAD drive line (connects to an external control box) can be visualized.
The lungs and pleural spaces are clear, and there is no pneumothorax. Pulmonary vasculature is normal and unchanged from previous imaging.
Sternotomy wires and suprasternal surgical clips are present.
The single-lead ICD sits in the left prepectoral region. Coils and leads extend through the superior vena cava to the right atrium.
The drive line runs from the LVAD pump, below the diaphragm and external to the patient's body. The inflow tract sits in the left ventricle and connects to the pump and then to the outflow tract, which leads to the ascending aorta.
Nil fractures, and no pleural or pericardial effusion. No suspicious pulmonary nodule or mass. Stable bilateral lower lobe reticular opacities, possibly fibrosis. No enlarged thoracic lymph nodes.
Liver, gallbladder, spleen, pancreas, right adrenal unremarkable. Stable 2 cm left adrenal nodule. Stable 18 x 14 mm non-avid soft tissue lesion at the left renal hilum. Bilateral renal cysts. The liver, gallbladder, spleen, pancreas and right adrenal are unremarkable. Visualized small and large bowel normal in caliber. Moderate proximal colonic diverticulosis.
Case Discussion
The case shows positioning of various parts of an implantable cardioverter-defibrillator and left ventricular assist device.
There were no significant findings on bloodwork; the patient was discharged.
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