Strategic Approach Towards the Evaluation of HeartMate 3 Left Ventricular Assist Devices Using Multimodality Imaging.

The use of left ventricular assist devices (LVADs) has increased in recent years as a destination therapy. The HeartMate 3 (HM3) is currently the only commercially available LVAD for implantation in the United States. Societal guidelines for multimodality cardiac imaging evaluation of LVADs and temporary mechanical support devices were recently published and serve as a comprehensive resource for the evaluation of LVAD patients. Our review provides a strategic approach towards transthoracic echocardiographic (TTE) assessment of LVADs as well as discusses the role and application of multimodality imaging in patients with HM3 LVADs. In conclusion, we provide a comprehensive TTE evaluation protocol that incorporates objective measurements and modified methods for assessing device and ventricular function along with evaluation of valves. Additionally, we address specific LVAD clinical scenarios, and the use of a multimodality diagnostic approach.