Spontaneous echocardiographic contrast in the ascending aorta mimicking the appearance of aortic dissection in a patient with a left ventricular assist device.

We describe a patient with a previously implanted Jarvik 2000 left ventricular assist device (LVAD), who presented with bacteraemia and with features suspected for aortic dissection at the CT scan. However, transesophageal echocardiography showed competition in the ascending aorta between the retrograde pump flow and the anterograde transaortic output, which mimicked true aortic dissection and could be resolved by lowering the pump speed. As patients with LVAD are increasing in number, clinicians should be aware of this possible effect.