Concomitant abdominal exploration with durable left ventricular assist device implantation

A 45-year-old male presented in decompensated heart failure from nonischemic cardiomyopathy and was implanted with a right transaxillary intra-aortic balloon pump. He was listed for heart transplantation but after 9 days, he developed abdominal pain with evidence of embolization on computed tomography scan despite a well-positioned balloon pump. He underwent concomitant abdominal exploration with small bowel resection and durable left ventricular assist device implantation. He recovered well and was discharged home. This case highlights the challenges of decision-making in the current era where intra-aortic balloon pumps are being utilized more frequently as a bridge to heart transplantation.