Continuous-Flow LVAD Support Causes a Distinct Form of Intestinal Angiodysplasia

Kang, Jooeun; Hennessy-Strahs, Samson; Kwiatkowski, Paweł; Bermúdez, C.; Acker, Michael A.; Atluri, Pavan; McConnell, Patrick I.; Bartoli, Carlo

doi:10.1161/circresaha.117.310848

Cited by 68 publications

(47 citation statements)

References 41 publications

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“…Transient GI translocation due to the low output-associated mucosal ischemia may be a less common source to consider. Continuous-Flow LVAD support causes a distinct form of intestinal angiodysplasia which presumably is responsible for GI bleeding and translocation of intestinal bacteria [4,23]. LVADs infection can also predispose or complicate any Case Reports in Infectious Diseases bacteremia including those caused by anaerobes.…”

Section: Discussionmentioning

confidence: 99%

Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure

Murillo-García

Galindo

Pinto

et al. 2019

Case Reports in Infectious Diseases

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Left ventricular assisted devices (LVADs) have revolutionized the treatment of advanced heart failure, providing meaningful increases in survival, functional capacity, and quality of life. There are two categories of LVADs patients: (1) bridge-to-transplant and (2) destination therapy. Advanced heart failure and destination LVADs often carry a poor prognosis. The overall 1-year mortality rate remains as high as 30%. LVAD-specific infections, LVAD-related infections, and non-LVAD-related infections represent important emerging clinical problems in this setting. With an incidence ranging from 30 to 50%, these lead to high rates of hospitalization, morbidity, and mortality. Bacteremias caused by anaerobic pathogens in patients with LVAD are underreported. Herein, we describe the microbiological findings, treatment, and clinical outcome of four patients with LVADs and advanced heart failure with anaerobic bacteremias. Fusobacterium species was the most frequent etiological agent. Most patients had a relatively favorable short-term outcome with survival rates of 100% at 30 days and of 50% at 90 days. However, due to other multiple long-term complications, overall mortality remains at 50% during the first year and increases to 75% beyond the first year. Anaerobic bacteremia sources included the oral cavity from odontogenic infections and aspiration pneumonia. Anaerobic bacteremia constitutes an unfavorable mortality prognostic factor in patients with destination LVADs. We recommend implementing preventive strategies with a comprehensive dental care evaluation in patients with LVADs and advanced heart failure.

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Section: Discussionmentioning

confidence: 99%

Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure

Murillo-García

Galindo

Pinto

et al. 2019

Case Reports in Infectious Diseases

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“…Capillary density was defined as the number of capillaries per HPF. Values for each image were averaged to obtain a single representative mean value per tissue section (38,39).…”

Section: Methodsmentioning

confidence: 99%

Fetal hypoxemia causes abnormal myocardial development in a preterm ex utero fetal ovine model

et al. 2018

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“…Plasma sampled from left ventricular assist device (LVAD) patients have higher serum levels of angiopoietin‐2 and promote endothelial angiogenesis in vitro through thrombin‐induced angiopoietin‐2 expression . Other authors suggest that the increase in circulating VWF degradation fragments in VWF‐type 2A, aortic stenosis and LVAD patients could promote the development of ADs in the gastrointestinal tract through a pro‐angiogenic effect . According to this hypothesis, the lack of HMW‐multimers does not account for the bleeding phenotype but rather the imbalanced between high and low MW‐multimers.…”

Section: Pathophysiology Of Bleeding Related To Vascular Malformationmentioning

confidence: 99%

Von Willebrand disease: Clinical conundrums

Leebeek

Susen

2018

Haemophilia

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In this short review, current clinical conundrums on von Willebrand disease (VWD) will be addressed. Despite more knowledge on the pathophysiology of VWD, improvement of diagnostic strategies and advances in clinical care for patients with VWD still several problems and dilemmas remain. In this review, the latest findings regarding the pathology, including controversial borders for definition of the disease, diagnostic dilemma when von Willebrand factor (VWF) levels evolve with age, laboratory issues rendering difficult the classification of the different types of VWD and the current principles of care, including prophylaxis, related to these issues will be addressed. In addition, the importance of the loss of high molecular weight (HMW) VWF multimers in a subset of patients with congenital or acquired von VWD, which can be associated with severe bleeding related to vascular malformations in the gastrointestinal tract or other tissues will be reviewed. Also, the therapeutic options that can be proposed for these severe and difficult to control bleeding episodes in patients with VWD will be discussed. | D IAG NOS IS AND CL A SS IFI C ATI ON OF V WDVon Willebrand disease is the most common autosomal inherited bleeding disorder, mainly characterized by mucocutaneous bleed- The ISTH VWF classification has been in use now for over 10 years, but has some limitations and some problems still arise to

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Continuous-Flow LVAD Support Causes a Distinct Form of Intestinal Angiodysplasia

Cited by 68 publications

References 41 publications

Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure

Anaerobic Bacteremias in Left Ventricular Assist Devices and Advanced Heart Failure

Fetal hypoxemia causes abnormal myocardial development in a preterm ex utero fetal ovine model

Von Willebrand disease: Clinical conundrums

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