Safety of conventional and wireless capsule endoscopy in patients supported with nonpulsatile axial flow Heart-Mate II left ventricular assist device

BackgroundLeft ventricular assist devices (LVADs) are increasingly being used as a bridge for cardiac transplantation in patients with decompensated cardiac function. A known complication of these devices is severe and sometimes life-threatening GI bleeding, usually related to the presence of angioectasias. Endoscopy has been generally accepted as safe in patients with cardiac disease and implanted cardiac devices, when it is performed with appropriate monitoring. However, the literature is sparse regarding the safety of endoscopy in patients with LVADs.ObjectiveGiven the potential risks for GI bleeding in this subgroup of patients, our aim was to shed light on the potential safety of endoscopy in these patients.DesignWe present our experience with endoscopic intervention for varied sources of GI bleeding in a group of patients with the HeartMate II implantable LVAD.SettingA tertiary care university-based hospital setting, Tampa General Hospital at the University of South Florida, Tampa, Florida.PatientsPatients with severe cardiomyopathy requiring cardiac support with the HeartMate II implantable LVAD.InterventionsPatients received upper and lower GI endoscopy as dictated by their clinical presentations. One patient received capsule endoscopy as well.ConclusionsWe observed that endoscopy, including capsule endoscopy, may be safely performed in these patients with appropriate monitoring.