Safety and Outcomes of Capsule Endoscopy in Patients with Left Ventricular Assist Device: a Single-Center Retrospective Case Series

Abstract

Obscure gastrointestinal bleeding (GIB) in patients with continuous-flow left ventricular assist devices (CF-LVAD) is common. Capsule endoscopy (CE) can be used in the diagnosis of obscure GIB. Safety and outcomes of CE in patients with CF-LVAD are unknown. The aim is to define the safety and outcomes of CE in this population. Paitents with CF-LVAD undergoing CE at a single center between 2007 and 2014 were retrospectively reviewed. Thirty-four CE studies were performed. Positive CE occurred in 19 studies. No clinically significant cardiac events occurred. Medical intervention was the most common management strategy. Rebleeding after CE occurred in 10 patients. Patients with active bleeding or lesions such as arteriovenous malformations (AVM) incurred a higher risk of rebleeding, transfusion, and repeated endoscopy. CE is safe in patients with CF-LVAD. The risk of rebleeding was more common in patients with active bleeding or AVM lesions although this result did not reach statistical significance.

Pooled Analysis of the Efficacy and Safety of Video Capsule Endoscopy in Patients with Implantable Cardiac Devices

“…A total of 16 original articles (10 retrospective and 6 prospective studies) [5–20], involving a total of 735 VCE procedures, were included in our analysis. The selected publications were sorted per year.…”

Video capsule endoscopy is safe and effective in suspected small bowel bleeding among left ventricular assist device recipients

“…Several studies have reported similar results. Hanson et al 19 described their experience with 34 video capsule endoscopies performed in left ventricular assist device recipients with 55% positive findings and no clinically significant cardiac adverse events.…”

Safety of wireless capsule endoscopy in patients with implantable cardiac devices

“…There is no consensus on how to best monitor the true short‐ and long‐term safety of this procedure and subsequent patient cardiac safety events. There are small retrospective studies that have evaluated the use of WCE in patients with cardiac devices, specifically focusing on the safety of such devices with regard to cardiac events . Although the initial data are promising, they comprise small case studies of only a handful of patients or are only focused on a specific cardiac device …”

“…There are small retrospective studies that have evaluated the use of WCE in patients with cardiac devices, specifically focusing on the safety of such devices with regard to cardiac events. [12][13][14] Although the initial data are promising, they comprise small case studies of only a handful of patients or are only focused on a specific cardiac device. 7,15,16 The primary aim of this study was to investigate adverse cardiac outcomes in patients with any implantable cardiac devices who had undergone WCE.…”