Reverberation and multiple shadow artifacts recorded from patients with intra-pericardial centrifugal continuous-flow left ventricular assist devices.

Artifacts are by-products of ultrasound imaging that may cause confusion or misdiagnosis if not interpreted correctly. There are, however, several disorders where a specific pattern of artifacts can aid in diagnosis, especially when the object in question cannot be visualized directly. In this manuscript, we report two patients with reverberation and shadow artifacts originating from the housing and the propeller of a continuous-flow intra-pericardial left ventricular assist device. Visualization of the artifacts required modified transthoracic views, so these artifacts should not pose a diagnostic challenge during a routine echocardiographic evaluation. However, we consider that shadow artifacts might be used to evaluate pump thrombosis in patients with intra-pericardial assist devices.