Echocardiography from a transhepatic approach in left ventricular assist device patients with difficult transthoracic imaging.

The transhepatic window may represent a good alternative in selected LVAD patients with very difficult acoustic access in traditional transthoracic views. Modified or alternate echocardiographic windows may reduce the need for invasive procedures (transoesophageal echocardiography) or imaging methods using radiations.