Bilateral endovascular uterine artery embolization for dysfunctional uterine artery bleeding with heartware left ventricular assist support device

We report a 40-year-old lady with post-partum cardiomyopathy for more than 4 years and had left ventricular assist device (LVAD) implantation. She was New York Heart Association Class IV and Interagency Registry for Mechanically Assisted Circulatory Support Level I. She had HeartWare (HeartWare Inc, Framingham, MA, USA) LVAD implantation. She was admitted to emergency department with dysfunctional uterine bleeding with a hemoglobin level 3 gr/dL and a hematocrit level 10%, 3 months postoperatively. The ultrasonographic evaluation revealed blood coagulum in the uterine cavity, she was diagnosed with dysfunctional uterine bleeding, and hospitalized. Since there was a probability of LVAD pump thrombosis, a surgical intervention was not planned. Gonadotropin releasing hormone analogue therapy and embolisation of bilateral uterine arteries prevented further dysfunctional uterine bleeding. We report the first case in the literature with advanced heart failure supported with LVAD and bilateral uterine artery embolization due to dysfunctional uterus artery bleeding with an endovascular procedure.