title: Effect of aortic valve movements on gastrointestinal bleeding that occured in continuous flow left ventricular assist device patients.
abstract: BACKGROUND
  Gastrointestinal (GI) bleeding is one of the recently reported complications with continuous flow left ventricular assist devices (LVAD). The pathophysiology and etiology are unclear. We sought to describe the relationship between aortic valve movements and GI bleeding among patients with a new generation of LVAD.
  
  
  METHODS
  We evaluated the data of 30 patients who underwent LVAD (HeartWare VAD) implantation from December 2010 to September 2012. The most common etiologic diagnosis was dilated cardiomyopathy. Patients were considered to show GI bleeding if they had hematemesis, melena, or hematochezia.
  
  
  RESULTS
  Among 3 patients, 2 displayed upper GI bleeding and 1 had lower GI bleeding based on endoscopic and colononoscopic examinations. Pathological reports showed arteriovenous malformations in patients diagnosed with upper GI bleeding. The absence of aortic valve movements and a history of previous GI bleeding were significant risk factors (P = .021 and P = .007, respectively).
  
  
  CONCLUSIONS
  In addition to aortic valve movements, we believe that a GI bleeding history was an equally important factor predisposing to this complication.
authors.affiliation: Department of Cardiovascular Surgery, Ege University Medical Faculty, Izmir, Turkey.
authors.forename: O
authors.initials: O
authors.lastname: Balcioglu
authors.forename: C
authors.initials: C
authors.lastname: Engin
authors.forename: T
authors.initials: T
authors.lastname: Yagdi
authors.forename: S
authors.initials: S
authors.lastname: Nalbantgil
authors.forename: B
authors.initials: B
authors.lastname: Baysal
authors.forename: S
authors.initials: S
authors.lastname: Erkul
authors.forename: Y
authors.initials: Y
authors.lastname: Engin
authors.forename: I
authors.initials: I
authors.lastname: Kutlayey
authors.forename: M
authors.initials: M
authors.lastname: Ozbaran
mesh_terms: D001021:Aortic Valve / Q000503:physiopathology*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000503:physiopathology*; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans