Octreotide for recurrent intestinal bleeding due to ventricular assist device

Area of Science:

• Cardiology
• Gastroenterology
• Vascular Medicine

Background:

• Continuous-flow ventricular assist devices (CF-VADs) like the Jarvik 2000 are crucial for end-stage heart failure management.
• Patients with CF-VADs often require anticoagulation, increasing bleeding risks.
• Acquired von Willebrand disease is a known complication associated with CF-VADs, further elevating hemorrhage risk.

Observation:

• A 64-year-old male recipient of a Jarvik 2000 device presented with intractable gastrointestinal hemorrhage.
• The patient had a high bleeding risk due to concurrent anticoagulation therapy and diagnosed acquired von Willebrand disease.
• Severe gastric angiodysplasia was identified as the cause of the severe bleeding.

Findings:

• The patient's intractable gastrointestinal bleeding was successfully managed.
• Treatment involved the administration of long-acting octreotide.
• Octreotide demonstrated efficacy in controlling hemorrhage from gastric angiodysplasia in this high-risk patient.

Implications:

• Long-acting octreotide represents a viable therapeutic option for managing severe gastrointestinal bleeding in high-risk CF-VAD patients.
• This case highlights the importance of recognizing and managing angiodysplasia-related bleeding in the VAD population.
• Further research may explore the role of octreotide in similar complex bleeding scenarios in mechanical circulatory support recipients.