Implantation of a left ventricular assist device is problematic in patients with prosthetic heart valves, due to an increased risk of thrombosis with embolization. This report describes the use of a bovine pericardial patch to close the aortic outflow tract in a patient with a mechanical aortic valve and end-stage cardiomyopathy who required urgent left ventricular assist support. A successful outcome suggests that this technique may be of value in treating similar patients.