title: Safety and Outcomes of Capsule Endoscopy in Patients with Left Ventricular Assist Device: a Single-Center Retrospective Case Series.
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.
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA. hans3829@umn.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Hanson
authors.affiliation: Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Ryan J
authors.initials: RJ
authors.lastname: Koene
authors.affiliation: Division of Cardiovascular Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Samit S
authors.initials: SS
authors.lastname: Roy
authors.affiliation: Minneapolis Heart Institute, Minneapolis, MN, USA.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Eckman
authors.affiliation: Department of Surgery, Cardiothoracic Surgery Division, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Ranjit
authors.initials: R
authors.lastname: John
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.|Health Partners Regions Hospital, Saint Paul, MN, USA.
authors.forename: Nadeem A
authors.initials: NA
authors.lastname: Chaudhary
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Jose
authors.initials: J
authors.lastname: Vega-Peralta
mesh_terms: D000368:Aged; D001165:Arteriovenous Malformations / Q000150:complications; D053704:Capsule Endoscopy / Q000009:adverse effects; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016277:Ventricular Function, Left
keywords: Arteriovenous malformations; Capsule endoscopy; Gastrointestinal hemorrhage; Heart-assist devices; Medical device safety