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Infection is a leading cause of death following left ventricular assist device (LVAD) implantation, but mold infections are rare. The authors describe what is, to their knowledge, the first reported case of an ambulatory patient with LVAD-associated Aspergillusinfection successfully treated in an outpatient setting with debridement, antifungal therapy, and device retention. His treatment course was complicated by emergence of triazole-resistance, which is becoming surprisingly more frequent, even among patients without severe immunocompromising conditions.Infection is a leading cause of death after left ventricular assist device implantation, but mold infections are rare. We present a unique case of localized Aspergillusleft ventricular assist device driveline exit site infection successfully treated with debridement, antifungal therapy, and device retention, but the course was complicated by emergence of triazole resistance.