Utility and safety of balloon-assisted enteroscopy in patients with left ventricular assist devices: a retrospective multicenter study. Journal Article

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Authors: Hasan, BM; McMahon, C; Khalid, RA; Colak, Y; Mayorga, DC; Elkafrawy, A; Tandon, K; Shafiq, M; Hussain, I; Erim, T; Castro, F; Charles, R; Chhabra, R
Article Title: Utility and safety of balloon-assisted enteroscopy in patients with left ventricular assist devices: a retrospective multicenter study.
Abstract: Patients with left-ventricular assist devices (LVADs) have an increased risk of gastrointestinal bleeding, especially from the small bowel, often necessitating evaluation with balloon-assisted enteroscopy (BAE). Our study aimed to assess the periprocedural safety and utility of BAE for gastrointestinal bleeding in patients with LVADs. This was a multicenter retrospective cohort study of adults with LVADs who underwent BAE between January 2007 to December 2018. Thirty-four patients underwent a total of 46 BAEs (9 were single-balloon enteroscopies [SBEs] and 37 were double-balloon enteroscopies [DBEs]). Mean age of patients was 66.4?±?8.3 years. Patients tolerated anesthesia well, without complications. There were no complications from the BAE itself. One patient required repeat BAE due to a progressive drop in hemoglobin and another patient developed paroxysmal supraventricular tachycardia. One patient died within 72 hours of the procedure due to worsening of LVAD?thrombosis. Diagnostic yields were 69.6?% for all procedures, 73.0?% for DBE and 55.6?% for SBE ( ?=?0.309). Therapeutic yields were 67.4?% overall: 73.0?% for DBE and 44.4?% for SBE ( ?=?0.102). In those that presented with overt gastrointestinal bleeding, DBE had a higher diagnostic yield compared to SBE (84.2?% vs. 42.9?%; ?=?0.057) and a significantly higher therapeutic yield (84.2?% vs. 28.6?%; p?=?0.014). This is the largest multicenter study of patients with LVADs who underwent DBE. BAE appears to be a safe and useful modality for the evaluation of gastrointestinal bleeding in these patients.
Journal Title: Endoscopy international open
ISSN: 2364-3722; 2196-9736
Publisher: Unknown  
Date Published: 2020