Vascular Abnormalities of the Nasal Mucosa Are Associated with Gastrointestinal Bleeding During Continuous Flow LVAD Support

Patel, Sneha; Saeed, Omar; Madan, Shivank; Algodi, Mohammed; Luke, A.; Gibber, Marc; Goldstein, Daniel J.; Jorde, Ulrich P.

doi:10.1016/j.healun.2016.01.230

Cited by 2 publications

(2 citation statements)

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“…Of interest, blood type A patients may exhibit lowest risk of bleeding[ 48 ], an factor that may play a role in risk-stratification of LVAD patients. Possible correlation to GIB may be found in patients with increased nasal hypervascularity after LVAD implantation[ 68 ] and may be potentially used to help risk stratify patients. Future research may provide additional insight into management of such patients, perhaps focusing on further definition of various parameters in individual anticoagulation therapy and recognizing patients with highest risk for bleeding at the time of LVAD implant.…”

Section: Managementmentioning

confidence: 99%

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients

Gurvits¹,

Fradkov²

2017

WJG

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Continuous-flow left ventricular assist devices (CF-LVADs) have significantly improved outcomes for patients with end-stage heart failure when used as a bridge to cardiac transplantation or, more recently, as destination therapy. However, its implantations carries a risk of complications including infection, device malfunction, arrhythmias, right ventricular failure, thromboembolic disease, postoperative and nonsurgical bleeding. A significant number of left ventricular assist devices (LVAD) recipients may experience recurrent gastrointestinal hemorrhage, mainly due to combination of antiplatelet and vitamin K antagonist therapy, activation of fibrinolytic pathway, acquired von Willebrand factor deficiency, and tendency to develop small intestinal angiodysplasias due to increased rotary speed of the pump. Gastrointestinal bleeding in LVAD patients remains a source of increased morbidity including the need for blood transfusions, extended hospital stays, multiple readmissions, and overall mortality. Management of gastrointestinal bleeding in LVAD patients involves multidisciplinary approach in stabilizing the patients, addressing risk factors and performing structured endoluminal evaluation with focus on upper gastrointestinal tract including jejunum to find and eradicate culprit lesion. Medical and procedural intervention is largely successful and universal bleeding cessation occurs in transplanted patients.

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Section: Managementmentioning

confidence: 99%

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients

Gurvits¹,

Fradkov²

2017

WJG

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show abstract

“…Furthermore, male gender and older age are recognizable risk factors [5]. There also seems to exist a possible correlation with GI hemorrhage in patients with easily observed nasal hypervascularity following LVAD implantation [13]. Additional variables will continue to emerge with increased utilization of the devices and associated interest in further clinical research.…”

mentioning

confidence: 99%

Gastrointestinal Hemorrhage in Left Ventricular Assist Device Patients: Red Scare or Pressure from the Right?

Gurvits

2018

Dig Dis Sci

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Vascular Abnormalities of the Nasal Mucosa Are Associated with Gastrointestinal Bleeding During Continuous Flow LVAD Support

Cited by 2 publications

References 0 publications

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients

Bleeding with the artificial heart: Gastrointestinal hemorrhage in CF-LVAD patients

Gastrointestinal Hemorrhage in Left Ventricular Assist Device Patients: Red Scare or Pressure from the Right?

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