Clinical Approach to Manage Gastrointestinal Bleeding with a Left Ventricular Assist Device (LVAD).
Publication/Presentation Date
12-10-2019
Abstract
Left ventricular assist devices (LVADs) are an exceedingly important form of mechanical support for patients with end-stage heart failure. LVADs can be utilized both as a bridge to cardiac transplant and also as a definitive treatment. However, a few complications are associated with LVAD placement, the most common and cumbersome of which is gastrointestinal (GI) bleeding with an incidence of about 30%. These bleeding events often require transfusion therapy, but they are rarely fatal. The etiologies of GI bleeding following LVAD are multifactorial and include unstable hemodynamics, an acquired von Willebrand factor (vWf) deficiency, impaired platelet aggregation, and activation of fibrinolytic systems. The treatment of choice in LVAD implantation-associated GI bleeding is endoscopy, which plays a vital role in both its diagnosis and management. Even so, its effectiveness in controlling post-LVAD implantation GI bleeding is still poorly ascertained. In this article, we will review the use of medication and alterations in the LVAD setting to prevent the occurrence of GI bleeding, as well as the findings of previously reported literature on LVAD implantation-associated GI bleeding.
Volume
11
Issue
12
First Page
6341
Last Page
6341
ISSN
2168-8184
Published In/Presented At
Ahsan, I., Faraz, A., Mehmood, A., Ullah, W., & Ghani, A. R. (2019). Clinical Approach to Manage Gastrointestinal Bleeding with a Left Ventricular Assist Device (LVAD). Cureus, 11(12), e6341. https://doi.org/10.7759/cureus.6341
Disciplines
Medicine and Health Sciences
PubMedID
31938629
Department(s)
Department of Medicine
Document Type
Article