Why the study?
Hemorrhagic ovarian cysts can cause life-threatening intraabdominal bleeding in patients with LVADs under strong antithrombotic therapy, and surgical incision sites are restricted to avoid damaging the LVAD driveline.
Can laparoscopic surgery safely achieve hemostasis in LVAD patients with intraabdominal bleeding from hemorrhagic ovarian cysts?
Can laparoscopic surgery safely achieve hemostasis in LVAD patients with intraabdominal bleeding from hemorrhagic ovarian cysts?
Laparoscopic surgery is a viable and safe option for managing intraabdominal bleeding from hemorrhagic ovarian cysts in patients with LVADs on antithrombotic therapy, as it allows for flexible incision sites to avoid driveline damage.
May support laparoscopic hemostasis for HOC bleeding in LVAD patients; hypothesis-generating and should not yet change practice.
Hemorrhagic ovarian cysts (HOCs), a common gynecological disease causing intraabdominal bleeding, can be life threatening in patients undergoing antithrombotic therapy, especially those with left ventricular assist device (LVAD) implantation under strong antithrombotic therapy. We encountered three postLVAD implantation cases with intraabdominal bleeding due to suspected HOCs, which required surgery for hemostasis. Such patients are not only at a higher risk of bleeding but also have restrictions in available surgical incision sites to avoid damaging the LVAD driveline located underneath the abdominal wall. Laparoscopic surgery, which can be performed through minute incisions with flexible site selection, may benefit intraabdominal hemorrhage patients with LVADs.
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Nakae et al. (2022) studied this question.
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