title: Novel Use of Thalidomide in Recurrent Gastrointestinal Tract Bleeding in Patients with Left Ventricular Assist Devices: A Case Series.
abstract: BACKGROUND
  Bleeding is an important and common complication of left ventricular assist devices (LVADs). One of the common causes of gastrointestinal bleeding is arteriovenous malformations. However, the source of bleeding is often hard to identify. Thalidomide is efficacious in treatment of gastrointestinal (GI) bleeding in non-LVAD patients. We report our experience of the use of thalidomide in the treatment of GI bleeding in four patients with LVAD.
  
  
  RESULTS
  Four patients who had recurrent GI bleeding from May 2009 to December 2014 were started on thalidomide. All of them responded to treatment and had no further gastrointestinal bleeding while on thalidomide. One patient developed constipation, requiring thalidomide to be stopped. Another patient developed symptomatic neuropathy, that resolved with reduction of dosage.
  
  
  CONCLUSIONS
  Thalidomide appears safe and efficacious in LVAD patients with recurrent gastrointestinal bleeding.
authors.affiliation: National Heart Centre, Singapore. Electronic address: laura.chan.lihua@singhealth.com.sg.
authors.forename: Laura Lihua
authors.initials: LL
authors.lastname: Chan
authors.affiliation: National Heart Centre, Singapore.
authors.forename: Choon Pin
authors.initials: CP
authors.lastname: Lim
authors.affiliation: National Heart Centre, Singapore.
authors.forename: Chong Hee
authors.initials: CH
authors.lastname: Lim
authors.affiliation: National Heart Centre, Singapore.
authors.forename: Teing Ee
authors.initials: TE
authors.lastname: Tan
authors.affiliation: National Heart Centre, Singapore.
authors.forename: David
authors.initials: D
authors.lastname: Sim
authors.affiliation: National Heart Centre, Singapore.
authors.forename: Cumaraswamy
authors.initials: C
authors.lastname: Sivathasan
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D009202:Cardiomyopathies / Q000601:surgery*; D004305:Dose-Response Relationship, Drug; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D006353:Heart-Assist Devices / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013792:Thalidomide / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D020533:Angiogenesis Inhibitors; D013792:Thalidomide
keywords: Gastrointestinal haemorrhage; Thalidomide; Ventricular assist devices