title: Partial nephrectomy in a patient with a left ventricular assist device.
abstract: Left ventricular assist device (LVAD) use has increased as a bridge to heart transplant as well as destination therapy in patients with severe heart failure. Presence of LVAD is not a contraindication to noncardiac surgery but does present special challenges to the surgical, anesthesia, and cardiac teams. We present the case of a 40-year-old woman with idiopathic cardiomyopathy necessitating LVAD who underwent left partial nephrectomy for a renal mass. She had undergone three nondiagnostic percutaneous image-guided biopsies. Left partial nephrectomy was performed. Perioperative care was without incident due to careful oversight by a multidisciplinary team. Pathology revealed high-grade clear cell renal cell carcinoma (RCC) with negative margins. Polytetrafluoroethylene (PTFE) bolsters were misidentified six months postoperatively on computed tomography (CT) at an outside institution as a retained laparotomy sponge. This is, to our knowledge, the first report of a partial nephrectomy performed in a patient with LVAD.
authors.affiliation: Department of Urology, University of Virginia, Charlottesville, VA 22908, USA.
authors.forename: Jules P
authors.initials: JP
authors.lastname: Manger
authors.forename: John A
authors.initials: JA
authors.lastname: Kern
authors.forename: Tracey L
authors.initials: TL
authors.lastname: Krupski