Abstract
Obscure gastrointestinal bleeding (GIB) in patients with continuous-flow left ventricular assist devices (CF-LVAD) is common. Capsule endoscopy (CE) can be used in the diagnosis of obscure GIB. Safety and outcomes of CE in patients with CF-LVAD are unknown. The aim is to define the safety and outcomes of CE in this population. Paitents with CF-LVAD undergoing CE at a single center between 2007 and 2014 were retrospectively reviewed. Thirty-four CE studies were performed. Positive CE occurred in 19 studies. No clinically significant cardiac events occurred. Medical intervention was the most common management strategy. Rebleeding after CE occurred in 10 patients. Patients with active bleeding or lesions such as arteriovenous malformations (AVM) incurred a higher risk of rebleeding, transfusion, and repeated endoscopy. CE is safe in patients with CF-LVAD. The risk of rebleeding was more common in patients with active bleeding or AVM lesions although this result did not reach statistical significance.
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Abbreviations
- GIB:
-
Gastrointestinal bleeding
- CF-LVAD:
-
Continuous-flow left ventricular assist devices
- CE:
-
Capsule endoscopy
- AVM:
-
Arteriovenous malformation
- IED:
-
Implantable electromechanical cardiac devices
- PM:
-
Pacemaker
- ICD:
-
Implantable cardioverter defibrillator
- Spect-CT:
-
Single-photon emission computerized tomography
- SB2:
-
Pill Cam SB capsule endoscope 2
- EGD:
-
Esophagogastroduodenoscopy
- APC:
-
Argon plasma coagulation
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Acknowledgments
The authors would like to thank Dr. Alexander Khoruts for his work in reading CE studies.
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Human Subjects/Informed Consent Statement
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was not necessary for the patients included in this study. The University of Minnesota Institutional Review Board reviewed and approved this study.
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Associate Editor Enrique Lara-Pezzi oversaw the review of this article
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Hanson, B.J., Koene, R.J., Roy, S.S. et al. Safety and Outcomes of Capsule Endoscopy in Patients with Left Ventricular Assist Device: a Single-Center Retrospective Case Series. J. of Cardiovasc. Trans. Res. 9, 402–404 (2016). https://doi.org/10.1007/s12265-016-9701-5
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DOI: https://doi.org/10.1007/s12265-016-9701-5