title: Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding.
abstract: OBJECTIVE
  To assess whether video capsule endoscopy (VCE) affects the outcomes of left ventricular assist devices (LVADs) recipients with gastrointestinal bleeding.
  
  
  METHODS
  This is a retrospective study of LVAD recipients with obscure gastrointestinal bleeding (OGIB) who underwent VCE at a tertiary medical center between 2005 and 2013. All patients were admitted and monitored with telemetry and all VCE and subsequent endoscopic procedures were performed as inpatients. A VCE study was considered positive only when P2 lesions were found and was regarded as negative if P1 or P0 were identified. All patients were followed until heart transplant, death, or the end of the study.
  
  
  RESULTS
  Between 2005 and 2013, 30 patients with LVAD underwent VCE. Completion rate of VCE was 93.3% and there was no capsule retention. No interference of VCE recording or the function of LVAD was found. VCE was positive in 40% of patients (n = 12). The most common finding was active small intestinal bleeding (50%) and small intestinal angiodysplasia (33.3%). There was no difference in the rate of recurrent bleeding between patients with positive and negative VCE study (50.0% vs 55.6%, P = 1.00) during an average of 11.6 ± 9.6 mo follow up. Among patients with positive VCE, the recurrent bleeding rate did not differ whether subsequent endoscopy was performed (50% vs 50%, P = 1.00).
  
  
  CONCLUSIONS
  VCE can be safely performed in LVAD recipients with a diagnostic yield of 40%. VCE does not affect recurrent bleeding in LVAD patients regardless of findings.
authors.affiliation: Surachai Amornsawadwattana, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: Surachai
authors.initials: S
authors.lastname: Amornsawadwattana
authors.affiliation: Surachai Amornsawadwattana, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: Michael
authors.initials: M
authors.lastname: Nassif
authors.affiliation: Surachai Amornsawadwattana, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: David
authors.initials: D
authors.lastname: Raymer
authors.affiliation: Surachai Amornsawadwattana, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: Shane
authors.initials: S
authors.lastname: LaRue
authors.affiliation: Surachai Amornsawadwattana, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, United States.
authors.forename: Chien-Huan
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000368:Aged; D053704:Capsule Endoscopy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006333:Heart Failure / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D013686:Telemetry; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
keywords: Capsule endoscopy; Digestive system; Endoscopy; Gastrointestinal hemorrhage; Heart failure; Heart-assist devices