"I need to reduce recovery time,
complications, and resources....
"I need to avoid fluid overload
during resuscitation...
"I need to see cardiac
filling and function...
"I need to know if it's tamponade
or desaturation...
"I need to get my critical
patients off vent faster...
so I use hemodynamic ultrasound."

Is hemodynamic transesophageal echocardiography needed for LVAD patients?

Wow, does Swan-Ganz cardiac monitoring miss a lot, according to our interpretation of Bahatyrevich et al, “Is hemodynamic transesophageal echocardiography needed for patients with left ventricular assist device?” (J Thorac Cardiovasc Surg 2018;155:1071-7).

What they did

They monitored 30 HeartMate II LVAD-implanted patients using Swan-Ganz catheter and ImaCor hemodynamic transesophageal echo (every 1-3 hours) simultaneously. They collected 147 hTEE studies and compared the differences between methodologies.

Hemodynamic ultrasound caught so much more

ImaCor found abnormalities in 26 of the 30 patients (87%). Swan-Ganz found none. Wow.

Among 30 patients, ImaCor found:

  • 19 with a shift in the interventricular septum;
  • 22 with abnormal ventricular volume status;
  • 9 with right ventricular failure; and,
  • 14 need an LVAD speed adjustment; and,

Argh!

Talk about first-mover advantage! Study after study shows how the ImaCor hemodynamic ultrasound method represents true cardiac function, ventricular volume status, and septal position in
patients with a left ventricular assist device.

Old habits are hard to break. Hemodynamically distressed patients need more.

Only you can decide if this article is worth sharing with your hospital – chances are, your fellow decision makers might miss this study. Share it, call ussomething!

PDFClick here to download the abstract.

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