Assessment of Peripheral Arterial (Normal) Flows in Multiple Vascular Territories in Patients Receiving Mechanical Cardiac Support

Background: In the last few years, mechanical circulatory support in patients with advanced/terminal heart failure (HF) is increasing. New devices have been developed from the known intra-aortic balloon pump to the total artificial heart. However, vascular complications may occur in up to 30% based on the device implanted. Evaluation of the Doppler flow in all vascular territories (cranial, extracranial, abdominal, and peripheral) in patients with these devices might be of great importance but remains still unexplored. This is a proof of concept study in which we provide a practical analysis of the Doppler waveform of different territories in patient with different mechanical circulatory support devices. Methods: Three patients with different mechanical circulatory support system (MCSS) were included in this analysis. Doppler evaluation of several vascular territories has been performed and compared with flow from normal heart. Patients with advanced HF supported by a mechanical circulatory system were included in this analysis. Results: A standard Doppler ultrasound has been performed to evaluate blood flow in the following vascular territories: middle cerebral artery, ophthalmic artery, common carotid artery, intraparenchymal renal artery, common femoral artery, and posterior tibial artery. Conclusions: This is the first report comparing Doppler waveforms between different MCSS. It may represent a practical guide for physicians evaluating the vascular pattern in these patients.