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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
PubMed

Insights

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.
Abstract

Keywords:
gastrointestinal bleedingmechanical cardiac supportventricular assist device

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