Original articleClinical endoscopyGI bleeding in patients with continuous-flow left ventricular assist devices: a systematic review and meta-analysis
Section snippets
Data sources and search strategy
We performed a literature search by using PubMed, SCOPUS, and the Cochrane Central Register of Clinical Trials (1990-2013) to identify full articles reporting the prevalence of GIB in patients with LVADs. We identified studies using the following medical subject headings (MeSH) and keywords including “left ventricular assist device” or “cardiac assist device” or “heart-assist device” and “gastrointestinal bleeding” or “gastrointestinal hemorrhage” or “complications” or “adverse events.” The
Study characteristics and quality
The literature search resulted in 2573 articles. After exclusion of duplicates, case reports, and review articles, 63 papers were assessed via full text for eligibility. Of these, 46 articles were excluded for various reasons (Fig. 1), leaving 17 papers describing the prevalence of GIB in continuous-flow LVAD patients included. The study cohort included 1839 patients, 1697 (92%) of whom had continuous-flow LVADs (Fig. 1). The characteristics of the patients enrolled in each study are shown in
Discussion
GIB is an astoundingly common occurrence in the post-LVAD implantation patient. In particular, GIAD appear to be the predominant cause of bleeding, especially in patients with continuous-flow devices. There is some preliminary evidence that shows that bleeding events cease after heart transplantation and LVAD device removal, although this was noted in only 12 patients in our study. The increased risk of bleeding is thought to be a combination of several factors. First, it has been demonstrated
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DISCLOSURE: All authors disclosed no financial relationships relevant to this article.
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