Left ventricular endocardial definition enhancement using perflutren microsphere contrast echocardiography during peripheral venoarterial extracorporeal membranous oxygenation.

Contrast echocardiography provides incremental benefit in patients with nondiagnostic imaging, particularly in the intensive care setting. There are minimal data regarding its use in patients on mechanical cardiac support devices. This case highlights the additional diagnostic information provided with contrast-enhanced imaging in a patient with shock, supported by a peripherally cannulated extra-corporeal membranous oxygenation (ECMO) device. The signal persistence was reduced compared to the conventional setting, as anticipated but the concentration of perflutren microspheres remained sufficient to provide satisfactory endocardial definition, despite passage through a centrifugal pump. There was no adverse affect on the patient's cardiorespiratory status or ECMO function.