Therapeutic strategy for gastrointestinal bleeding in patients with left ventricular assist device

Left ventricular assist device (LVAD) technology has improved the survival of advanced heart failure patients. However, readmission rates following LVAD implantation remain high and are an unsolved matter. Currently, gastrointestinal bleeding is one of the major causes of readmission and has recently been demonstrated to mainly result from increased angiogenesis. In addition to the conventional therapeutic strategies, including a reduction in antiplatelet and anticoagulation therapies and blood products administration, several therapeutic tools have recently been proposed: octreotide, thalidomide, hemodynamic optimization by the ramp test, and fish oil therapy. This review will update the therapeutic strategy for gastrointestinal bleeding in LVAD patients.