Introduction
Left ventricular assist devices (LVADs) have become integral to the
treatment of advanced heart failure. Surgical bleeding is a common
complication of LVAD implantation, with rates reported as high as 60%;
the majority of cases require surgical
intervention.1,2 The intrapericardial design of
centripetal flow LVADs may reduce the risk of surgical bleeding by
obviating the need for a preperitoneal or intraperitoneal pocket to
house the pump. However, recent studies have shown no convincing
evidence of this.2,3 Here we describe an unusual
source of surgical bleeding after intrapericardial LVAD placement caused
by erosion into an intercostal artery.