GI bleed with Continuous flow LVAD – Mechanisms
GI bleed with Continuous flow LVAD – Mechanisms
Gastrointestinal bleeds can occur in 15-40% of patients on continuous flow left ventricular assist devices (LVAD) for end stage heart failure. Proposed mechanisms for gastrointestinal bleeds with continuous flow LVAD includes:
Acquired von Willebrand disease
Impaired platelet aggregation
Enhanced angiogenesis causing arteriovenous malformations (AVM)
Intensity of anticoagulation
AVMs may contribute to about half of the GI bleed with continuous flow LVADS. Hypoperfusion of gastrointestinal mucosa leads to angiogenesis and the new friable vessels are prone for bleeding [1].
Reference
Guha A, Eshelbrenner CL, Richards DM, Monsour HP Jr. Gastrointestinal bleeding after continuous-flow left ventricular device implantation: review of pathophysiology and management. Methodist Debakey Cardiovasc J. 2015 Jan-Mar;11(1):24-7.
Source: Cardiophile MD - Category: Cardiology Authors: Prof. Dr. Johnson Francis Tags: Cardiac Surgery Source Type: blogs
More News: Bleeding | Cardiology | Gastroenterology | Heart | Heart Failure | von Willebrand Disease