Role of echocardiography in the perioperative management of mechanical circulatory assistance

Ventricular assist devices are electromechanical pumps used for circulatory support of patients with severe heart failure. Current ventricular assist device therapy provides a broad spectrum of support systems ranging from short-term to long-term devices. Echocardiography is an ideal modality to monitor patients undergoing mechanical circulatory support because it is less invasive, widely available and can be performed at the bedside. Both long-term and short-term devices require a careful echocardiographic management before implant, during surgical procedure and during postoperative course. Perioperative echocardiographic examination is performed to assess cardiac abnormalities that could lead to postoperative complications, to evaluate the surgical result and to determine reasons of postoperative haemodynamic compromises. Cannulae visualisation, patent forame ovale (PFO), air in cardiac chambers, aortic and or mitral regurgitation, right-ventricular function, left-ventricular unloading and filling, tamponade and pump failure are the most important issues discussed in this review.