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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
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Blood Supply to the Digestive System01:16

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Splanchnic circulation refers to the network of blood vessels that supply and drain blood from the abdominal organs involved in digestion, including the stomach, liver, pancreas, intestines, and spleen. This circulation delivers essential nutrients and oxygen while removing waste products from these organs.
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Related Experiment Video

Updated: Jul 26, 2025

Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
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Gastrointestinal bleeding on continuous-flow left ventricular assist device therapy.

Yoav Hammer1, Abbas Bitar1, Keith D Aaronson1

  • 1Division of Cardiovascular Disease, Michigan Medicine - University of Michigan, Ann Arbor, MI, USA.

ESC Heart Failure
|June 16, 2023
PubMed
Summary

Continuous-flow left ventricular assist device (CF-LVAD) recipients frequently experience gastrointestinal bleeding (GIB), a common and serious adverse event. This review examines GIB causes, risks, and treatments in CF-LVAD patients.

Keywords:
Arteriovenous malformationsContinuous-flow left ventricular assist deviceGastrointestinal bleedingHeartmate 3

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Area of Science:

  • Cardiovascular Surgery
  • Medical Device Technology
  • Gastroenterology

Background:

  • Continuous-flow left ventricular assist devices (CF-LVADs) are crucial for advanced heart failure management.
  • Despite technological progress, CF-LVAD recipients face significant adverse events, most commonly gastrointestinal bleeding (GIB).
  • Post-LVAD GIB severely impacts quality of life, necessitating hospital admissions, transfusions, and potentially leading to mortality.

Purpose of the Study:

  • To review the etiology, incidence, and risk factors of post-LVAD GIB.
  • To evaluate current and emerging treatment options for GIB in CF-LVAD recipients.
  • To discuss the influence of next-generation CF-LVADs on GIB occurrence and management.

Main Methods:

  • This is a review article, synthesizing existing literature on post-LVAD GIB.
  • Information was gathered from registry data and published studies.
  • Focus is on identifying risk factors, treatment efficacy, and device-related effects.

Main Results:

  • Gastrointestinal bleeding is the most frequent adverse event in CF-LVAD recipients.
  • Recurrent GIB is common, exacerbating patient morbidity.
  • Evidence for current medical and endoscopic treatments is largely equivocal, with limited clinical trial data.

Conclusions:

  • Effective pre-implant screening tools to predict GIB are lacking.
  • Further research, including clinical trials, is needed to establish optimal GIB management strategies.
  • Understanding and mitigating GIB risk is critical for improving outcomes in CF-LVAD patients.