Implantation of a Left Ventricular Assist Device With Concomitant Repair of Ascending Aortic Aneurysm

Left ventricular assist device (LVAD) placement with concomitant cardiac procedures carries a similar procedural risk to isolated LVAD implantation. However, due to low rates of occurrence, data on concomitant procedural outcomes for patients with both ascending aortic aneurysms and end-stage heart failure requiring mechanical circulatory support are limited.

We describe the successful concomitant treatment of aortic and left ventricular disease in a 62-year-old man who presented with acute-on-chronic congestive heart failure.

Although surgical intervention is currently only recommended for aneurysms at 5.0 cm, in this case, the decision for concomitant aneurysm resection was based on the thin-walled nature of the aorta, concern about wall shear stresses, and potential acceleration of aneurysm growth with an LVAD in place.

This case demonstrates the feasibility of addressing both the short- and long-term issues of aortic aneurysm growth and heart failure disease with an acceptable level of risk.