The paper presents collaboration of an abdominal surgeon and heart team in deciding upon surgical management of a patient with the implanted left ventricular assist device, who has undergone emergency abdominal operation for spleen rupture. The paper focuses on the significance of prompt diagnostics, clinical challenges of hemodynamic and anticoagulant treatment, abdominal organ exposure along the placed left ventricular assist device driveline, identification of vascular structures in conditions of continuous blood flow, and reconstruction of the surgical wound in the driveline projection.