Successful pregnancy with centrifugal flow left ventricular assist device: A case report and review of the literature

Abstract

Successful deliveries from patients supported by axial flow left ventricular devices have been previously reported. We present the first case of a successful pregnancy and birth in a patient with a centrifugal-flow left ventricular assist device. A 24-year-old female with methamphetamine-induced cardiomyopathy and end-stage congestive heart failure supported by a HeartWare™ ventricular assist device (Medtronic) presented two years after device implantation with an unplanned pregnancy at 11-weeks of gestation. Following a multidisciplinary evaluation by experts in advanced heart failure, maternal fetal medicine, cardiothoracic surgery, anesthesia, ethics, psychiatry, and palliative care, an advanced plan of care was established. An elective induction of labor was scheduled for the 34th week of gestation. Given poor labor progression despite maximal induction efforts, the patient was transferred to a cardiothoracic operating room where she delivered a healthy baby boy via Cesarean section under close hemodynamic monitoring by advanced heart failure and cardiothoracic surgery teams.