Key result
Octreotide, hemodynamic optimization, and omega-3 therapy show promise for managing GI bleeding in LVAD patients.
Gastrointestinal bleeding in LVAD patients is a major cause of readmission driven by angiogenesis, and emerging therapies like octreotide and omega-3 supplementation offer promising targeted management strategies.
These strategies merit consideration in refractory LVAD bleeding; leaves open confirmation of benefit in prospective trials.
Left ventricular assist device (LVAD) technology has improved the survival of advanced heart failure patients. However, readmission rates following LVAD implantation remain high and are an unsolved matter. Currently, gastrointestinal bleeding is one of the major causes of readmission and has recently been demonstrated to mainly result from increased angiogenesis. In addition to the conventional therapeutic strategies, including a reduction in antiplatelet and anticoagulation therapies and blood products administration, several therapeutic tools have recently been proposed: octreotide, thalidomide, hemodynamic optimization by the ramp test, and fish oil therapy. This review will update the therapeutic strategy for gastrointestinal bleeding in LVAD patients.
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Imamura et al. (2018) conducted a review in Gastrointestinal bleeding in patients with left ventricular assist devices. Therapeutic strategies for gastrointestinal bleeding (e.g., octreotide, omega-3, hemodynamic optimization) was evaluated. Novel therapeutic strategies, including octreotide, hemodynamic optimization, and omega-3 therapy, offer promising approaches to manage and prevent gastrointestinal bleeding in patients with left ventricular assist devices.
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