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Prostate artery embolization in a patient with left ventricular assist device

Jay Vasani1, Sanghun Kim2, Kieran Hynes3

  • 1Department of Diagnostic Radiology, University of Mississippi Medical Center, 2500 N State St. Jackson, Mississippi, 39216, USA.

Urology Case Reports
|February 8, 2021
PubMed

Insights

Left ventricular assist device (LVAD) recipients with advanced heart failure may require non-cardiac procedures. This case study details a successful prostate artery embolization in a patient with a HeartWare HVAD device, managing refractory hematuria.

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.

Keywords:
Benign prostatic hyperplasiaInterventional radiologyLeft ventricular assist deviceLower urinary tract symptomProstate artery embolization

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