Partial Nephrectomy in a Patient with a Left Ventricular Assist Device

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...

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Main Authors: Jules P. Manger, John A. Kern, Tracey L. Krupski
Format: Article
Language:English
Published: Wiley 2011-01-01
Series:Case Reports in Urology
Online Access:http://dx.doi.org/10.1155/2011/526903
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author Jules P. Manger
John A. Kern
Tracey L. Krupski
author_facet Jules P. Manger
John A. Kern
Tracey L. Krupski
author_sort Jules P. Manger
collection DOAJ
description 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.
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spelling doaj-art-56f074aae7f94c249b30fd31efc2b53b2025-02-03T01:25:34ZengWileyCase Reports in Urology2090-696X2090-69782011-01-01201110.1155/2011/526903526903Partial Nephrectomy in a Patient with a Left Ventricular Assist DeviceJules P. Manger0John A. Kern1Tracey L. Krupski2Department of Urology, University of Virginia, Charlottesville, VA 22908, USADivision of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Virginia, Charlottesville, VA 22908, USADepartment of Urology, University of Virginia, Charlottesville, VA 22908, USALeft 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.http://dx.doi.org/10.1155/2011/526903
spellingShingle Jules P. Manger
John A. Kern
Tracey L. Krupski
Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
Case Reports in Urology
title Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
title_full Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
title_fullStr Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
title_full_unstemmed Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
title_short Partial Nephrectomy in a Patient with a Left Ventricular Assist Device
title_sort partial nephrectomy in a patient with a left ventricular assist device
url http://dx.doi.org/10.1155/2011/526903
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AT traceylkrupski partialnephrectomyinapatientwithaleftventricularassistdevice