ABSTRACT
Patients with critical cardiorespiratory failure have been increasingly treated with mechanical circulatory support over the last three decades. Internal and external mechanical pumps and blood oxygenators have sustained life while transplant donor organs are obtained or the heart and lungs of the patient recover. In recent years, destination therapy has been applied to patients in whom organ recovery is not expected, with the implantation of long-term pump devices. The mechanical and hydraulic nature of these treatments and the associated risks of foreign body infection and thrombosis lead to myriad potential complications. Echocardiography (transthoracic echocardiography [TTE], transesophageal echocardiography [TEE], and contrast) has proved to be the backbone of imaging in these patients. The nonphysiologic nature of the circulation in these patients requires unique understanding and interrogation as outlined in this chapter.
