Continuous-Flow Left Ventricular Assist Device-Related Gastrointestinal Bleeding

Abstract

Continuous-flow (CF) left ventricular assist devices (LVADs) are a safe and durable therapeutic option for patients with advanced heart failure as a bridge to transplant or as destination therapy. Despite the remarkable technological advances in device design and increasing familiarity with the physiologic effects of CF, major complications such as gastrointestinal bleeding (GIB) continue to cause significant morbidity. The causes underlying CF-LVAD-related GIB are multifactorial. Accordingly, management strategies for CF-LVAD-related GIB encompass a wide range of therapeutic modalities. This article reviews the epidemiology, pathophysiology, risk factors, and treatment options for the management of this complex complication.

Keywords: Angiodysplasia; Gastrointestinal bleed; Left ventricular assist device; Octreotide.