Transesophageal echocardiographic evaluation of patients receiving mechanical assistance from ventricular assist devices

Ventricular assist devices (VADs) have been successfully used to provide circulatory support for patients with cardiogenic shock after cardiac surgery. Transesophageal echocardiography plays a vital role in the evaluation of patients on VAD support: it is used to verify the correct positioning of the VAD hardware; to diagnose complications, including intracardiac thrombus and tamponade; and to assess right and left ventricular function when VAD flow is decreased to determine the correct timing for weaning from the device. Future developments may allow us to prospectively identify patients with stunned but viable myocardium who would benefit the most from VAD support.