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Updated: Apr 4, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Outcomes of Patients with Left Ventricular Assist Devices Undergoing Mesenteric Angiography for Gastrointestinal
Amar Mehta1, Stephanie Kim1, Osman Ahmed1
1Department of Radiology, University of Chicago Medical Center, 5841 S. Maryland Ave., MC 2026, Chicago, IL 60637.
Insights
Patients with left ventricular assist devices (LVADs) experiencing gastrointestinal bleeding had worse outcomes. They required more interventions and had higher mortality compared to controls, indicating clinical failure.
Area of Science:
- Cardiology
- Gastroenterology
- Interventional Radiology
Background:
- Gastrointestinal (GI) bleeding is a serious complication in patients with left ventricular assist devices (LVADs).
- Anticoagulation therapy in LVAD patients can increase bleeding risk.
- Mesenteric angiography is a diagnostic tool for GI bleeding.
Purpose of the Study:
- To compare clinical success rates between LVAD patients and controls undergoing mesenteric angiography for GI bleeding.
- To evaluate the need for subsequent interventions and mortality in these patient groups.
Main Methods:
- Retrospective study of 48 patients (24 LVAD, 24 control) with GI bleeding assessed by angiography.
- Statistical analysis using chi-squared and t tests.
- Comparison of outcomes including bleeding detection, interventions, and mortality.
Main Results:
- Lower detection rate of bleeding on angiography in LVAD patients (8.3% vs 33.3%).
- Higher rates of clinical failure (33.3% vs 87.5%) and repeat angiography within 14 days (29.2% vs 4.5%) in LVAD patients.
- Increased in-hospital mortality (16.7% vs 4.2%) for LVAD patients.
Conclusions:
- Patients with LVADs experiencing GI bleeding demonstrate a higher rate of clinical failure.
- LVAD patients require more frequent repeat angiography and subsequent interventions.
- Higher mortality rates underscore the severity of GI bleeding in LVAD recipients.
Purpose:
To compare measures of clinical success, such as the need for subsequent intervention and mortality, in patients with left ventricular assist devices (LVADs) undergoing mesenteric angiography for gastrointestinal (GI) bleeding with respect to a control group.
Materials And Methods:
A retrospective study was conducted on 48 consecutive patients undergoing anticoagulation whose GI bleeding was assessed with angiography between August 2007 and June 2014: 24 patients with LVADs and 24 control patients without LVADs. The χ2 and t tests were used for statistical analysis.
Results:
Mean ages were 62.1 years ± 9.6 and 74.5 years ± 11.3 in the LVAD and control groups, respectively. No significant difference was observed in hemodynamic instability, presenting hemoglobin level and International Normalized Ratio, or hemoglobin nadir. Two patients with LVADs (8.3%) and 8 control patients (33.3%) had bleeding detected on angiograms (P = .032). Six embolizations were performed in patients with LVADs and 8 were performed in control patients. Clinical success was achieved in 2 of 6 patients with LVADs (33.3%) and 7 of 8 control patients (87.5%; P = .036). Seven patients with LVADs (29.2%) and 1 control patient (4.5%) underwent repeat angiography within 14 days (P = .020). Seven patients with LVADs (29.2%) and 4 control patients (18.2%) required postprocedural endoscopic or operative intervention as definitive therapy (P = .302). All-cause in-hospital mortality rates were 16.7% in the LVAD group and 4.2% in the control group (P = .032), and the respective all-cause 1-year mortality rates were 33.3% and 9.1% (P = .080).
Conclusions:
A higher rate of clinical failure is observed in patients with LVADs presenting with GI bleeding compared with those without LVADs, with a more frequent need for subsequent endoscopic or surgical intervention.
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