With the growing rate of left ventricular assist device (LVAD) implantation, patients with end-stage heart failure and LVAD support are presenting for a variety of noncardiac surgeries. We describe a case of urgent posterior lumbar decompression for spinal stenosis in a 73-year-old man with HeartMateII LVAD, which presented significant anesthetic challenges in terms of positioning, blood loss, and coagulopathy.
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