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We aimed to elucidate the clinical relevance of transcranial Doppler (TCD) in the detection of microembolic signals in patients with Heartmate II (HM-II). Twenty patients with HM-II underwent TCD examinations, and microembolic signals were rarely detected in stable patients. However, they were detected in patients with hemolysis and/or thromboembolic events. Further, TCD examination under oxygen inhalation revealed that, both, solid emboli and gaseous emboli exist in patients with HM-II.