Gastrointestinal bleeding in recipients of the HeartWare Ventricular Assist System

JACC. Heart Failure
Daniel J GoldsteinADVANCE Investigators

Abstract

This study evaluated gastrointestinal bleeding (GIB) in patients receiving the HeartWare HVAD System (HeartWare Inc., Framingham, Massachusetts) in the pivotal BTT (Bridge to Transplant) trial and under the continued access protocol (CAP). GIB has become a significant problem for recipients of continuous flow device left ventricular assist devices (CF-LVAD). The need for anticoagulation and antiplatelet therapies complicates the management of GIB. Bleeding events from 382 patients with advanced heart failure (140 patients enrolled in the BTT trial, and an additional 242 CAP patients) were analyzed. Post-implant anticoagulation consisted of heparin followed by warfarin at a target international normalized ratio of 2 to 3. Acetylsalicylic acid was recommended at 81 to 325 mg. Overall, 59 of 382 (15.4%) patients experienced 108 GIB events (0.27 events per patient year). Mean time to first bleed was 273.1 days and 86.1% of events occurred beyond 30 days. Freedom from GIB was 84.1% at 1 year. Median international normalized ratio at the time of first bleed was 2.4 ± 1.4. The most common etiology of bleeding identified was arteriovenous malformation and the most common site was the small intestine. Repeat bleeding was infrequent, tho...Continue Reading

References

Jan 18, 2005·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·George V LetsouO H Frazier
Sep 1, 2007·The New England Journal of Medicine·Leslie W MillerUNKNOWN HeartMate II Clinical Investigators
Jan 22, 2009·The Journal of Thoracic and Cardiovascular Surgery·Sheri CrowLyle Joyce
Nov 19, 2009·The New England Journal of Medicine·Mark S SlaughterUNKNOWN HeartMate II Investigators
Mar 25, 2010·Journal of Cardiac Surgery·David R SternDaniel J Goldstein
Aug 27, 2010·Circulation. Heart Failure·Jennifer CowgerTheodore J Kolias
Sep 28, 2010·The Annals of Thoracic Surgery·Sheri CrowNestor Villamizar-Ortiz
Mar 19, 2011·Journal of the American College of Cardiology·Martin StrueberUNKNOWN HeartWare Investigators
May 3, 2011·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Zumrut T DemirozuO H Frazier
Mar 20, 2012·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jeffrey A MorganRobert J Brewer
May 1, 2012·The Annals of Thoracic Surgery·Ashim AggarwalGeetha Bhat
May 24, 2012·Circulation·Keith D AaronsonUNKNOWN HeartWare Ventricular Assist Device (HVAD) Bridge to Transplant ADVANCE Trial Investigators
Mar 14, 2013·The Annals of Thoracic Surgery·Stephen J ForestDaniel J Goldstein
Mar 16, 2013·Journal of Gastroenterology and Hepatology·Yen-Ling PengFa-Yauh Lee
May 28, 2013·The Annals of Thoracic Surgery·Bruce D Spiess
Jun 26, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Mark S SlaughterUNKNOWN HeartWare Bridge to Transplant ADVANCE Trial Investigators
Jul 4, 2013·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Stephen L RennysonRajiv Malhotra
Sep 3, 2013·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Joshua B FrenchShajan Peter
Sep 12, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·John M StulakFrancis D Pagani
Dec 10, 2013·Journal of the American College of Cardiology·Andrew J BoyleUNKNOWN HeartMate II Clinical Investigators
Mar 4, 2014·Asian Cardiovascular & Thoracic Annals·Guillaume CoutanceMassimo Massetti
Apr 11, 2014·The New England Journal of Medicine·J Eduardo RameMichael A Acker

❮ Previous
Next ❯

Citations

Jan 23, 2016·Thrombosis and Haemostasis·Antoine RauchSophie Susen
Oct 27, 2015·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Wiley D TrussShajan Peter
Nov 26, 2015·Future Cardiology·Jasmin S HankeJan D Schmitto
Sep 9, 2015·Frontiers in Surgery·Joshua C GrimmAshish S Shah
Aug 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jonathan ByrnesAngela Lorts
Aug 4, 2016·BMC Cardiovascular Disorders·Fatemeh EsmaeilzadehPhilippe van de Borne
Dec 21, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Diyar SaeedArtur Lichtenberg
Feb 21, 2018·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Erik N SorensenErika D Feller
May 6, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Simon MaltaisRobert L Kormos
Jul 1, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Ankit BhatiaNir Uriel
Apr 28, 2020·General Thoracic and Cardiovascular Surgery·Vishal Y ParikhReynolds M Delgado
Jun 14, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Douglas L JenningsJean M Connors
Jul 1, 2017·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Snehal R PatelUlrich P Jorde
Apr 12, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Masashi KawaboriJeffrey A Morgan
Oct 21, 2015·Current Cardiology Reports·Julie L Rosenthal, Randall C Starling
May 18, 2019·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Evgenij V PotapovFinn Gustafsson
Nov 20, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Faraz S AhmadMark J Ricciardi
Dec 24, 2017·Journal of Thrombosis and Haemostasis : JTH·R MuslemF W G Leebeek
Dec 20, 2018·Circulation·Jason J HanPavan Atluri
Jun 25, 2019·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Brady S MoffettSebastian Tume
May 10, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Ko SakatsumeYoshikatsu Saiki
Jan 7, 2017·The International Journal of Artificial Organs·Thomas SchlöglhoferNeil Wrightson
May 11, 2019·The American Journal of Emergency Medicine·Brit LongWilliam Brady
Nov 23, 2020·The Annals of Thoracic Surgery·Arman KilicRema Padman
Aug 24, 2021·Artificial Organs·Erik N SorensenErika D Feller

❮ Previous
Next ❯

Related Concepts

Related Feeds

Artificial Heart & Ventricular Assist Devices

Total artificial hearts (TAH) and ventricular assist devices (VADs) provide cardiac support for patients with end-stage heart disease and have significantly improved the survival of these patients. Discover the latest research on Artificial Heart and Ventricular Assist Devices here.

Bacteriotherapy (ASM)

Bacteriotherapy, also known as fecal transplantation, involves the transfer of stool from a healthy donor into the gastrointestinal tract for the purpose of treating recurrent C. difficile colitis. Here is the latest on bacteriotherapy.

Bacteriotherapy

Bacteriotherapy, also known as fecal transplantation, involves the transfer of stool from a healthy donor into the gastrointestinal tract for the purpose of treating recurrent C. difficile colitis. Here is the latest on bacteriotherapy.

Anemia

Anemia develops when your blood lacks enough healthy red blood cells. Anemia of inflammation (AI, also called anemia of chronic disease) is a common, typically normocytic, normochromic anemia that is caused by an underlying inflammatory disease. Here is the latest research on anemia.

Blood Clotting Disorders

Thrombophilia includes conditions with increased tendency for excessive blood clotting. Blood clotting occurs when the body has insufficient amounts of specialized proteins that make blood clot and stop bleeding. Here is the latest research on blood clotting disorders.

Related Papers

The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Ranjit JohnHeartWare Bridge to Transplant ADVANCE Trial Investigators
The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Samer S NajjarHVAD Bridge to Transplant ADVANCE Trial Investigators
The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Emma J BirksADVANCE Trial Investigators
The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
Mark S SlaughterHeartWare Bridge to Transplant ADVANCE Trial Investigators
© 2021 Meta ULC. All rights reserved