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The incidence, risk factors, and outcomes of gastrointestinal bleeding in patients with a left ventricular assist device: a Japanese single-center cohort study

  • Masatoshi AkiyamaEmail author
  • Kou Sakatsume
  • Konosuke Sasaki
  • Satoshi Kawatsu
  • Ichiro Yoshioka
  • Goro Takahashi
  • Kiichiro Kumagai
  • Osamu Adachi
  • Yoshikatsu Saiki
Original Article Artificial Heart (Clinical)
  • 26 Downloads

Abstract

Continuous flow-left ventricular assist devices (CF-LVADs) have become a therapeutic option in the management of advanced heart failure. Several studies show that patients with CF-LVAD are at an increased risk of gastrointestinal bleeding (GIB). However, few reports have presented the characteristics of GIB in Japanese populations. We investigated the incidence, etiology, and outcome of GIB in patients with CF-LVAD. Records of adult patients who received CF-LVADs between October 2008 and January 2017 were reviewed. GIB was defined as detection of bleeding sites by any type of diagnostic imaging. 54 patients received CF-LVAD, of which eight (14%) presented with overt GIB (12 events). GIB patients are significantly older (p = 0.04) and their pre-operative inferior vena cava diameter was larger (p = 0.02). Multivariate analysis revealed that the use of Jarvik 2000 (p = 0.003) was a risk factor for GIB. In total, 85.8% of patients were free from GIB at 1 year. The most common site was the small intestine (67%). The most common cause was angiodysplasia (50%). Six patients required blood transfusion (nine events) and four underwent endoscopic clippings (five events); however, no patients needed surgeries. The incidence of GIB in our cohort was similar to the global registry data. Double balloon endoscopy is useful for diagnosis and treatment of small intestinal lesions. Future efforts to further understand the incidence of GIB in Japanese populations by multicenter data are needed.

Keywords

Ventricular assist device Gastrointestinal bleeding Double balloon enteroscopy 

Notes

Acknowledgements

The authors thank Dr. Satoshi Miyata (Evidence-based Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan) for his cooperation for statistical analysis and correction of statistical terminology.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Japanese Society for Artificial Organs 2019

Authors and Affiliations

  1. 1.Division of Cardiovascular SurgeryTohoku University Graduate School of MedicineSendaiJapan

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