Prostate artery embolization in a patient with left ventricular assist device

Area of Science:

• Cardiology
• Interventional Radiology
• Urology

Background:

• Advanced heart failure management increasingly involves left ventricular assist devices (LVADs).
• Patients with LVADs face a growing need for non-cardiac interventions.
• Prostate artery embolization (PAE) is an established treatment for lower urinary tract symptoms and refractory hematuria of prostatic origin.

Observation:

• A patient with a HeartWare Ventricular Assist Device (HVAD) presented with refractory gross hematuria of prostatic origin (RHPO).
• The patient's clinical scenario necessitated a careful multidisciplinary evaluation to balance procedural risks and benefits.
• The decision was made to proceed with prostate artery embolization.

Findings:

• Prostate artery embolization was technically successful in the patient with the HeartWare HVAD.
• The procedure effectively managed the refractory hematuria, indicating feasibility in this complex patient population.
• No immediate periprocedural complications were noted.

Implications:

• This case demonstrates the feasibility and safety of performing prostate artery embolization in LVAD patients.
• A multidisciplinary approach is crucial for optimizing care in LVAD patients undergoing non-cardiac procedures.
• Further research may explore the long-term outcomes of PAE in LVAD recipients.