Biventricular assist device implantation as bridge to heart transplantation concomitant with open repair of infrarenal aortic aneurysm.

Abdominal aortic aneurysm (AAA) is very frequently accompanied by coronary artery disease. Myocardial ischemia is the leading cause of mortality and morbidity in AAA repair. Therapeutic strategy, in presence of ischemic heart failure and AAA, is not well established. Actually, AAA is considered as a contraindication to ventricular assist device (VAD) support. We report a unique case of concomitant open AAA repair and biVAD implantation in a patient with severe ischemic heart failure. This case argues that AAA should no longer be considered a contraindication for VAD implantation, provided the AAA repair is made before or simultaneously with device placement.