Left ventricular assist devices (LVADs) are increasingly being used as both bridge-to-transplantation and destination therapy in patients with severe congestive heart failure. Performing noncardiac surgical procedures in patients with LVADs represents a unique challenge given the anatomic, hemodynamic, and hematologic considerations in these patients. We present the case of a man with an LVAD who successfully underwent right upper lobectomy for a pulmonary nodule. The literature on thoracic surgery procedures in LVAD patients and the intraoperative and postoperative management of these patients are also reviewed.