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Gastrointestinal Bleeding in Mechanical Cardiac Support
Alexander P McNally1, Nicholas L Bandy1, Colten Yahn1
16040Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
The American Surgeon
|September 1, 2020
Summary
Gastrointestinal bleeding (GIB) affects over 25% of patients on mechanical cardiac support (MCS), with higher risks in those with comorbidities. Early endoscopy and careful anticoagulation management are crucial for these patients.
Area of Science:
- Cardiology
- Gastroenterology
- Medical Devices
Background:
- Mechanical cardiac support (MCS) is vital for heart failure patients.
- Gastrointestinal bleeding (GIB) is a significant risk associated with MCS.
- Understanding GIB incidence and risk factors in MCS patients is critical.
Purpose of the Study:
- To determine the incidence of GIB in patients receiving mechanical cardiac support.
- To identify risk factors associated with GIB in this patient population.
Main Methods:
- Retrospective review of patients (2009-2018) with durable and nondurable MCS.
- Evaluation of clinical records for demographics, GIB characteristics, and interventions.
- Univariate and multivariate analyses to identify risk factors.
Main Results:
- 25.9% of 427 patients experienced 218 GIB episodes.
- GIB incidence reached 44.9% by 6 months and 60.6% by 12 months.
- Hypertension, diabetes, pulmonary, hepatic, and renal diseases were associated with higher bleeding rates. Angiodysplasia was the most common cause.
Conclusions:
- GIB is a significant adverse event in MCS patients.
- Careful management of anticoagulation is essential.
- Early endoscopic evaluation is important for diagnosis and treatment.
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