Synthetic ECG-gated cardiac computed tomography for in vivo imaging of the temporary total artificial heart

To date, there have been >1000 implantations of temporary total artificial hearts (TAH-t). As expected, complications related to the use of the TAH-t can occur.1 A noninvasive imaging modality that would be capable of diagnosing mechanical failure, surgical complications, and thromboembolic phenomena related to the TAH-t is desirable. Echocardiography is not suitable to evaluate a TAH-t because ultrasound cannot penetrate air and the polyurethane components in the TAH-t assembly. Cardiac magnetic resonance imaging is likewise unsuitable because of the susceptibility to artifacts that the titanium valve components in the TAH-t would create. Conventional computed tomography (CT) is limited by motion artifact.2 Cardiac CT (CCT) can produce motion-artifact–free images of the heart. If performed with retrospective gating, CCT can also be used to acquire time-resolved images. However, CCT requires simultaneous recording of the patient’s ECG, and patients who have a TAH-t do not generate an ECG. Consequently, a variation in technique is necessary to image patients with TAH-t with this modality. Detailed below …