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Previous studies suggest that patients with left ventricular assist devices (LVADs) are at excess risk for gastrointestinal bleeding. To investigate this issue, researchers retrospectively analyzed data on 154 patients with end-stage heart failure who underwent LVAD implantation during a 10-year period in a single U.S. hospital.
During a mean follow-up of 0.9 years, 44 episodes of gastrointestinal bleeding occurred in 29 patients (19%). Bleeding was overt in 31 episodes and occult in 13. Risk factors for bleeding were a history of anticoagulation prior to LVAD implantation and older age. Causes of bleeding were primarily peptic ulcers (14) and vascular malformations (12), but no diagnosis was made in 13 episodes. Upper gastrointestinal endos…