Video capsule endoscopy in left ventricular assist device recipients with obscure gastrointestinal bleeding

AIM: To assess whether video capsule endoscopy(VCE) affects the outcomes of left ventricular assist devices(LVADs) recipients with gastrointestinal bleeding.METHODS: This is a retrospective study of LVAD recipients with obscure gastrointestinal bleeding(OGIB) who underwent VCE at a tertiary medical center between 2005 and 2013. All patients were admitted and monitored with telemetry and all VCE and subsequent endoscopic procedures were performed as inpatients. A VCE study was considered positive only when P2 lesions were found and was regarded as negative if P1 or P0 were identified. All patients were followed until heart transplant, death, or the end of the study.RESULTS: Between 2005 and 2013, 30 patients with LVAD underwent VCE. Completion rate of VCE was 93.3% and there was no capsule retention. No interference of VCE recording or the function of LVAD was found. VCE was positive in 40% of patients(n = 12). The most common finding was active small intestinal bleeding(50%) and small intestinal angiodysplasia(33.3%). There was no difference in the rate of recurrent bleeding between patients with positive and negative VCE study(50.0% vs 55.6%,P = 1.00) during an average of 11.6 ± 9.6 mo follow up. Among patients with positive VCE, the recurrent bleeding rate did not differ whether subsequent endoscopy was performed(50% vs 50%, P = 1.00).CONCLUSION: VCE can be safely performed in LVAD recipients with a diagnostic yield of 40%. VCE does not affect recurrent bleeding in LVAD patients regardless of findings.