Left ventricular assist device in pregnancy: case report of a near-term delivery with multidisciplinary support

Left ventricular assist devices (LVADs) are utilized to treat end-stage heart failure (HF) refractory to pharmacologic and device-based therapies. LVAD use is considered a relative contraindication to pregnancy due to concerns for increased maternal and foetal risk. Nonetheless, there is an increasing prevalence of LVAD use in pregnant patients with advanced HF. Data have been limited to case reports without guidelines for pregnancy management, and there are no reports of delivery beyond the 34th week of pregnancy.

We present a case of a pregnant person with an LVAD who underwent an uncomplicated near-term induction with an unscheduled caesarean delivery without cardiac decompensation or hypertensive disorders. She received multidisciplinary care throughout her antenatal, intrapartum, and postpartum course.

In LVAD patients with stable haemodynamics, managed by a multidisciplinary team in an appropriately resourced hospital, there may not be a need for planned preterm delivery.