Primary and Secondary Prevention Strategies for Gastrointestinal Bleeding in Patients with Left Ventricular Assist Device: A Systematic Review and Network Meta-analysis

Rai, Devesh; Tariq, Raseen; Tahir, Muhammad Waqas; Chowdhury, Medhat; Wahab, Abdul; Kharsa, Adnan; Bandyopadhyay, Dhrubajyoti; Feitell, Scott; Parikh, Vishal; Aronow, Wilbert S.; Lanier, Gregg M.; Levine, Elliot J.; Fonarow, Gregg C.; Kaul, Vivek

doi:10.1016/j.cpcardiol.2021.100835

Cited by 8 publications

(8 citation statements)

References 32 publications

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“…For example, to prevent infection, researchers have been designing less invasive, completely implanted VADs [27,28]. For gastrointestinal bleeding after VAD implantation, the risk can be decreased by using thalidomide, omega-3-fatty acids, octreotide, and danazol to optimize management [29]. Research on the bleeding mechanism is also in progress [30,31].…”

Section: Discussionmentioning

confidence: 99%

The Development of Ventricular Assist Devices over the Past 30 Years: A Bibliometric Analysis

Liu,

Zheng,

Zhang

et al. 2024

CVIA

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Background: A large gap exists between the needs of patients with end-stage heart failure and the number of gold-standard heart transplants. Over the past 30 years, a revolutionary treatment strategy using ventricular assist devices (VADs) has rapidly developed and become widely used in clinical practice. However, few analyses have assessed the application and publication trends in the VAD field. Method: We used the Web of Science core collection to identify VAD research published between 1992 and 2022. We performed analysis and data visualization with CiteSpace, Scimago Graphica, and VOSviewer. Results: We identified 13,274 articles published in 1129 journals, describing work from 6351 institutions in 86 countries. Among them, the United States contributed the most to VAD research, and almost all the top ten authors and institutions contributing to VAD research were from the United States. Conclusions: In the past 5 years, VAD research has focused on right heart failure, outcomes, effects and risk factors, societies of surgeons, and clinical guidelines. Because of the large number of patients with heart failure, we expect VAD development to peak in the next decade.

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Section: Discussionmentioning

confidence: 99%

The Development of Ventricular Assist Devices over the Past 30 Years: A Bibliometric Analysis

Liu,

Zheng,

Zhang

et al. 2024

CVIA

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“…Three recent meta‐analysis examined the relation between ACEI/ARB treatment and GIB in LVAD patents. Two of them concluded that this treatment did mitigate GIB (odds ratio 0.35 [0.22–0.56] and 0.58 [0.34–0.98]), 49,50 while the other did not (hazard ratio 0.46 [0.16–1.3] 51 . In summary, although evidence is equivocal, it appears that ACEI/ARB might provide certain protection from GIB events, and their use seems reasonable.…”

Section: Medical Managementmentioning

confidence: 99%

“…Two of them concluded that this treatment did mitigate GIB (odds ratio 0.35 [0.22-0.56] and 0.58 [0.34-0.98]), 49,50 while the other did not (hazard ratio 0.46 [0.16-1.3]. 51 In summary, although evidence is equivocal, it appears that ACEI/ARB might provide certain protection from GIB events, and their use seems reasonable. As none of the mentioned studies, including those in the meta-analyses were randomized clinical trials, a definitive judgement as to benefits of ACEI/ARB with respect to GIB cannot be made.…”

Section: Angiotensin-converting Enzyme Inhibitor/angiotensin Receptor...mentioning

confidence: 99%

Gastrointestinal bleeding on continuous‐flow left ventricular assist device therapy

2023

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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.

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“…The prophylactic treatment of choice for GI bleeds in LVAD patients is octreotide [52]. Multiple studies demonstrate its efficacy in decreasing the frequency of LVAD-associated GI bleeds, the need for pRBC and PCC/FFP transfusions, and the length of hospitalization [53,54]. Octreotide limits blood pressures in the portal venous system secondary to vasodilation, increasing platelet adhesion, and preventing angiogenesis [17,53].…”

Section: Assessment and Management -Long-term Gi Bleedingmentioning

confidence: 99%

Thrombotic and Hemorrhagic Complications Following Left Ventricular Assisted Device Placement: An Emphasis on Gastrointestinal Bleeding, Stroke, and Pump Thrombosis

Phan,

Elgendi,

Javeed

et al. 2023

Cureus

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The left ventricular assist device (LVAD) is a mechanical circulatory support device that supports the heart failure patient as a bridge to transplant (BTT) or as a destination therapy for those who have other medical comorbidities or complications that disqualify them from meeting transplant criteria. In patients with severe heart failure, LVAD use has extended survival and improved signs and symptoms of cardiac congestion and low cardiac output, such as dyspnea, fatigue, and exercise intolerance. However, these devices are associated with specific hematologic and thrombotic complications. In this manuscript, we review the common hematologic complications of LVADs.

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Primary and Secondary Prevention Strategies for Gastrointestinal Bleeding in Patients with Left Ventricular Assist Device: A Systematic Review and Network Meta-analysis

Cited by 8 publications

References 32 publications

The Development of Ventricular Assist Devices over the Past 30 Years: A Bibliometric Analysis

The Development of Ventricular Assist Devices over the Past 30 Years: A Bibliometric Analysis

Gastrointestinal bleeding on continuous‐flow left ventricular assist device therapy

Thrombotic and Hemorrhagic Complications Following Left Ventricular Assisted Device Placement: An Emphasis on Gastrointestinal Bleeding, Stroke, and Pump Thrombosis

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