Gastrointestinal Bleeding during Continuous-Flow Left Ventricular Assist Device Support is Associated with Lower...

Area of Science:

• Cardiology
• Gastroenterology
• Transplantation

Background:

• Gastrointestinal bleeding (GIB) is a frequent complication following continuous-flow left ventricular assist device (CF-LVAD) implantation.
• The impact of GIB on cardiac transplantation outcomes in CF-LVAD patients is not well understood.

Purpose of the Study:

• To identify risk factors for GIB in CF-LVAD patients.
• To evaluate the association between GIB and the rate of subsequent cardiac transplantation.

Main Methods:

• Retrospective review of 232 patients who received a HeartMate II CF-LVAD.
• Analysis of GIB episodes, transfusion rates, and cardiac transplantation outcomes.
• Statistical analysis to determine risk factors and transplant rates.

Main Results:

• The incidence of GIB was 27% (0.45 episodes/patient-year).
• Women represented a higher proportion of GIB cases (29%) compared to their cohort representation (15%).
• GIB was associated with a 27% lower rate of cardiac transplantation in eligible patients (rate ratio 0.73, p < 0.05).

Conclusions:

• GIB is a significant complication after CF-LVAD implantation.
• GIB may reduce cardiac transplantation rates, potentially mediated by increased blood transfusions and allosensitization.