August 2015

This guideline addresses the role of echocardiography during the different phases of care of patients with long-term, surgically implanted continuous-flow (CF) left ventricular (LV) assist devices (LVADs). In patients with advanced heart failure (HF) refractory to medical therapy, LVADs have been used as a bridge to transplantation (BTT), as destination therapy (DT), as a bridge to transplant candidacy, or as a bridge to recovery. Over the past three decades, tremendous progress has been made in the field of mechanical circulatory support (MCS), and more than 30,000 patients worldwide have received long-term LVADs. Recent guidelines endorse the important role of echocardiography in the clinical care of LVAD patients at several stages, including preoperative patient selection, perioperative imaging, postoperative surveillance, optimization of LVAD function, troubleshooting of LVAD alarms, and evaluation of native myocardial recovery. Despite increasing clinical use of LVADs, recognition of the central role of echocardiography in their management, and presentation of an exponentially expanding outpatient LVAD population to healthcare facilities not directly associated with implantation centers, there is a lack of published guidelines for echocardiography of LVAD recipients. NOTE: A multimodality update for this guideline was published in 2024, please see Supplementary Materials below for link, both the 2015 & 2024 are valid.