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Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices 

Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
Chapter:
Gastrointestinal Bleeding in Patients with Left Ventricular Assist Devices
Author(s):

Shivtej Kaushal

and Nunzio Gaglianello

DOI:
10.1093/med/9780190909291.003.0034
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date: 07 June 2020

Continuous-flow, left ventricular assist devices (CF-LVADs) offer multiple advantages over older, pulsatile left ventricular assist devices (PF-LVADs). However, the reported rate of gastrointestinal bleeding (GIB) for CF-LVADs is between 18% and 40%, which is two to four times higher than the GIB rate for PF-LVADs. Proposed pathophysiological mechanisms include the mechanics of continuous flow, abnormal platelet aggregation, and the need for therapeutic anticoagulation. Treatment can be challenging in these patients but should always be systematic and mainly involves endoscopic and medical therapy. Over the past decade, advances in both of these areas have allowed practioners to stabilize and treat these patients effectively. Given the advances in these therapies, GIB has become a manageable condition in these otherwise complex patients.

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