# Urgent Spinal Surgery in a Lateral Decubitus on a Patient with a Left Ventricular Assist Device on Full Anticoagulation: A Case Report

## TL;DR

This case report shows that spinal surgery can be safely performed on a patient with a heart pump while they remain on blood thinners.

## Contribution

The novel approach uses a lateral decubitus position to safely perform spinal surgery on LVAD patients without reversing anticoagulation.

## Key findings

- Spinal surgery was successfully performed on a patient with a left ventricular assist device.
- The lateral decubitus position avoided the risks of the prone position and anticoagulation reversal.
- This approach may improve surgical options for non-ambulatory patients awaiting heart transplants.

## Abstract

This case report aims to demonstrate the feasibility of performing spinal surgery in patients with a left ventricular assist device (LVAD), who are traditionally considered unsuitable candidates due to the need for anticoagulation and the challenges associated with the prone position.

A case of a patient with an LVAD undergoing microdiscectomy in the left lateral decubitus position is presented. The procedure was carried out by a specialized interdisciplinary team with appropriate monitoring.

The patient underwent the procedure safely, demonstrating that spinal surgery can be performed in patients with LVAD without reversing anticoagulation or resorting to the prone position. This approach mitigates the risk of thrombotic events and hemodynamic instability.

This case study suggests that spinal surgery, specifically microdiscectomy, can be safely performed in patients with LVAD using the left lateral decubitus position. This finding has significant implications for patients who are unable to ambulate and therefore struggle to qualify for a heart transplant.