Published online May 28, 2020. doi: 10.3748/wjg.v26.i20.2550
Peer-review started: February 25, 2020
First decision: April 22, 2020
Revised: May 2, 2020
Accepted: May 14, 2020
Article in press: May 14, 2020
Published online: May 28, 2020
Core tip: Left ventricular assist devices are becoming increasingly common as life-prolonging therapy in advanced heart failure. However, left ventricular assist devices have shown high rates of gastrointestinal bleeding with 18%-40% of patients having episodes of bleed. Arteriovenous malformations are primarily responsible, which can be both challenging to control and cause many patients to discontinue essential anti-platelet and anti-coagulation therapies. Small bowel lesions are common in this population, frequently requiring small bowel endoscopic evaluation. For refractory cases, medical management is required including octreotide, thalidomide, angiotensin converting enzyme inhibitors/angiotensin II receptor blockers, estrogen-based therapies, desmopressin, doxycycline or bevacizumab to prevent further gastrointestinal bleeding.