Gastrointestinal bleeding in a patient with a continuous-flow biventricular assist device

• 作 者: Raymond V Mirasol Jason J Tholany Hasini Reddy Billie S Fyfe-Kirschner Christina L Cheng Issam F Moubarak John L Nosher
• 机 构: Department of Internal Medicine,Jersey Shore University Medical Center,Department of Radiology,Rutge
• 出 处: World Journal of Radiology
• 发表日期: 2016年04期
• 关键词: bleeding assist malformation dilated hemoglobin arteriovenous pathology understo

The association between continuous-flow left ventricular assist devices(CF-LVADs)and gastrointestinal(GI)bleeding from angiodysplasia is well recognized.However,the association between continuous-flow biventricular assist devices(CF-BIVADs)and bleeding angiodysplasia is less understood.We report a case of GI bleeding from a patient with a CF-BIVAD.The location of GI bleeding was identified by nuclear red blood cell bleeding scan.The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology.The intensity of bleeding,reflected by number of units of packed red blood cells needed for normalization of hemoglobin,as well as the time to onset of bleeding after transplantation,are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs.While angiography only detected a dilated late draining vein,pathology demonstrated the presence of both arterial and venous dilation in the submucosa,vascular abnormalities characteristic of a late arteriovenous malformation.

The association between continuous-flow left ventricular assist devices (CF-LVADs) and gastrointestinal (GI) bleeding from angiodysplasia is well recognized. Despite, the association between continuous-flow biventricular assist devices (CF- BIVADs) and bleeding angiodysplasia is less understood. We report a case of GI bleeding from a patient with a CF-BIVAD. The location of GI bleeding was identified by nuclear red blood cell bleeding scan. The vascular malformation leading to the bleed was identified and localized on angiography and then by pathology. intensity of bleeding, reflected by number of units of packed red blood cells needed for normalization of hemoglobin, as well as the time to onset of bleeding after transplantation, are similar to that seen in the literature for CF-LVADs and pulsatile BIVADs. While angiography only detected a dilated late draining vein, pathology demonstrated the presence of both arterial and venous dilation in the submucosa, vascular abnormalities characteristic of a late arteriovenous malformation.