Assist devices

Abstract Echocardiography is an indispensable tool in managing patients with an assist device. Before implantation, not only left ventricular but also right ventricular function should be evaluated because right ventricular dysfunction has a critical role in predicting outcomes. After implantation, echocardiography is used for optimization of an assist device settings and detecting possible complications such as right ventricular failure, progressive aortic regurgitation, and thrombosis. Pump malfunction causes changes in ventricular geometry and valve function which can be also detected by echocardiography. In some patients, left ventricular reverse remodelling occurs and an assist device can be weaned. Thus, follow-up of a patient after an assist device implantation with echocardiography is important. Mechanically, circulatory support with a ventricular assist device for end-stage heart failure or shock is a life-saving procedure. It is used for a bridge-to-recovery, a bridge-to-transplantation, or a destination therapy for those without an indication of transplantation and requires long-term support. The role of echocardiography in the management of patients with assist devices includes assessment of cardiac function, optimization of device settings, detection of complications, and evaluation of a possibility of weaning from a device.