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Review
. 2023 Aug;10(4):2214-2224.
doi: 10.1002/ehf2.14433. Epub 2023 Jun 15.

Gastrointestinal bleeding on continuous-flow left ventricular assist device therapy

Yoav Hammer  1 , Abbas Bitar  1 , Keith D Aaronson  1
Affiliations
Review

Gastrointestinal bleeding on continuous-flow left ventricular assist device therapy

Yoav Hammer et al. ESC Heart Fail. 2023 Aug.

Abstract

While technological advances in the field of continuous-flow left ventricular assist device (CF-LVAD) are constantly being made, CF-LVAD recipients are still subjected to a relatively high rate of LVAD-related adverse events, with post-LVAD gastrointestinal bleeding (GIB) being the most common one. GIB is associated with a significant impairment in quality of life, multiple hospital admissions, blood transfusion requirements and possibly death. Furthermore, of those patients who bled once, many will experience recurrent GIB events, which further aggravates their discomfort. While some medical and endoscopic treatment options are available, evidence regarding their benefit remains largely equivocal, with all related studies based on data from registries rather than clinical trials. Although having a major impact on LVAD recipients, an effective and validated pre-implant screening options to predict GIB events post-implant are scarce. This review focuses on the aetiology, incidence, risk factors, treatment options and the effect of new generation devices on post-LVAD GIB.

Keywords: Arteriovenous malformations; Continuous-flow left ventricular assist device; Gastrointestinal bleeding; Heartmate 3.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
Suggested algorithm for the management of gastrointestinal bleeding in patients with CF‐LVAD. EGD, oesophagogastric duodenoscopy; GI, gastrointestinal; HF, heart failure; LVAD, left ventricular assist device; IR, interventional radiology; VCE, video capsule endoscopy.
See this image and copyright information in PMC

References

    1. Kormos RL, Cowger J, Pagani FD, Teuteberg JJ, Goldstein DJ, Jacobs JP, Higgins RS, Stevenson LW, Stehlik J, Atluri P, Grady KL, Kirklin JK. The Society of Thoracic Surgeons Intermacs Database Annual Report: evolving indications, outcomes, and scientific partnerships. J Heart Lung Transplant. 2019; 38: 114–126. - PubMed
    1. Yuzefpolskaya M, Schroeder SE, Houston BA, Robinson MR, Gosev I, Reyentovich A, Koehl D, Cantor R, Jorde UP, Kirklin JK, Pagani FD, D’Alessandro DA. The Society of Thoracic Surgeons Intermacs 2022 Annual Report: focus on the 2018 Heart Transplant Allocation System. Ann Thorac Surg. 2023; 115: 311–327. - PubMed
    1. Mehra MR, Uriel N, Naka Y, Cleveland JC Jr, Yuzefpolskaya M, Salerno CT, Walsh MN, Milano CA, Patel CB, Hutchins SW, Ransom J, Ewald GA, Itoh A, Raval NY, Silvestry SC, Cogswell R, John R, Bhimaraj A, Bruckner BA, Lowes BD, Um JY, Jeevanandam V, Sayer G, Mangi AA, Molina EJ, Sheikh F, Aaronson K, Pagani FD, Cotts WG, Tatooles AJ, Babu A, Chomsky D, Katz JN, Tessmann PB, Dean D, Krishnamoorthy A, Chuang J, Topuria I, Sood P, Goldstein DJ, MOMENTUM 3 Investigators . A fully magnetically levitated left ventricular assist device ‐ final report. N Engl J Med. 2019; 380: 1618–1627. - PubMed
    1. Mehra MR, Crandall DL, Gustafsson F, Jorde UP, Katz JN, Netuka I, Uriel N, Connors JM, Sood P, Heatley G, Pagani FD. Aspirin and left ventricular assist devices: rationale and design for the international randomized, placebo‐controlled, non‐inferiority ARIES HM3 trial. Eur J Heart Fail. 2021; 23: 1226–1237. - PMC - PubMed
    1. Kataria R, Jorde UP. Gastrointestinal bleeding during continuous‐flow left ventricular assist device support: state of the field. Cardiol Rev. 2019; 27: 8–13. - PubMed

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