Intractable hematuria after left ventricular assist device implantation: Can lessons learned from gastrointestinal bleeding be applied?

Andre Y. Son, Lee Zhao, Alex Reyentovich, Abelardo DeAnda, Leora B. Balsam

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Patients with continuous-flow left ventricular assist devices (CF-LVADs) are at increased risk of bleeding. We reviewed our institutional experience with bleeding in the urinary tract after CF-LVAD implantation and quantified the impact on hospital resource utilization in comparison with bleeding in the gastrointestinal (GI) tract, the most commonly reported mucosal site of bleeding after LVAD implantation. Records were retrospectively reviewed for patients undergoing CF-LVAD implantation at our institution between October 2011 and April 2015. Major adverse events of gross hematuria and GI bleeding were identified, and patient demographics and hospital course were reviewed. Gross hematuria occurred in 3 of the 35 patients (8.6%) and in 5.1% of all hospitalizations for CF-LVAD patients. Severe hematuria occurred after traumatic urethral catheterization, urinary retention, or urologic surgery. Hospitalization for hematuria was six times less likely than hospitalization for GI bleeding; however, hematuria hospitalizations lasted 3.2 times longer than GI bleeding hospitalizations (17.0 vs. 5.3 days). Late recurrent gross hematuria occurred in all cases, with rehospitalization occurring after 109 ± 53 days. In conclusion, gross hematuria is an infrequent but morbid bleeding complication in CF-LVAD patients. Strategies to avoid this complication include strict avoidance of traumatic urethral catheterization and urinary retention in highrisk patients.

Original languageEnglish (US)
Pages (from-to)e8-e12
JournalASAIO Journal
Volume62
Issue number1
DOIs
StatePublished - 2016
Externally publishedYes

Fingerprint

Left ventricular assist devices
Heart-Assist Devices
Hematuria
Hemorrhage
Hospitalization
Urinary Catheterization
Urinary Retention
Surgery
Urinary Tract
Gastrointestinal Tract
Demography

Keywords

  • bleeding
  • hematuria
  • left ventricular assist device

ASJC Scopus subject areas

  • Biophysics
  • Biomaterials
  • Bioengineering
  • Biomedical Engineering
  • Medicine(all)

Cite this

Intractable hematuria after left ventricular assist device implantation : Can lessons learned from gastrointestinal bleeding be applied? / Son, Andre Y.; Zhao, Lee; Reyentovich, Alex; DeAnda, Abelardo; Balsam, Leora B.

In: ASAIO Journal, Vol. 62, No. 1, 2016, p. e8-e12.

Research output: Contribution to journalArticle

@article{db3ad10484774ef8b6df2ae9c2c52c3d,
title = "Intractable hematuria after left ventricular assist device implantation: Can lessons learned from gastrointestinal bleeding be applied?",
abstract = "Patients with continuous-flow left ventricular assist devices (CF-LVADs) are at increased risk of bleeding. We reviewed our institutional experience with bleeding in the urinary tract after CF-LVAD implantation and quantified the impact on hospital resource utilization in comparison with bleeding in the gastrointestinal (GI) tract, the most commonly reported mucosal site of bleeding after LVAD implantation. Records were retrospectively reviewed for patients undergoing CF-LVAD implantation at our institution between October 2011 and April 2015. Major adverse events of gross hematuria and GI bleeding were identified, and patient demographics and hospital course were reviewed. Gross hematuria occurred in 3 of the 35 patients (8.6{\%}) and in 5.1{\%} of all hospitalizations for CF-LVAD patients. Severe hematuria occurred after traumatic urethral catheterization, urinary retention, or urologic surgery. Hospitalization for hematuria was six times less likely than hospitalization for GI bleeding; however, hematuria hospitalizations lasted 3.2 times longer than GI bleeding hospitalizations (17.0 vs. 5.3 days). Late recurrent gross hematuria occurred in all cases, with rehospitalization occurring after 109 ± 53 days. In conclusion, gross hematuria is an infrequent but morbid bleeding complication in CF-LVAD patients. Strategies to avoid this complication include strict avoidance of traumatic urethral catheterization and urinary retention in highrisk patients.",
keywords = "bleeding, hematuria, left ventricular assist device",
author = "Son, {Andre Y.} and Lee Zhao and Alex Reyentovich and Abelardo DeAnda and Balsam, {Leora B.}",
year = "2016",
doi = "10.1097/MAT.0000000000000276",
language = "English (US)",
volume = "62",
pages = "e8--e12",
journal = "ASAIO Journal",
issn = "1058-2916",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Intractable hematuria after left ventricular assist device implantation

T2 - Can lessons learned from gastrointestinal bleeding be applied?

AU - Son, Andre Y.

AU - Zhao, Lee

AU - Reyentovich, Alex

AU - DeAnda, Abelardo

AU - Balsam, Leora B.

PY - 2016

Y1 - 2016

N2 - Patients with continuous-flow left ventricular assist devices (CF-LVADs) are at increased risk of bleeding. We reviewed our institutional experience with bleeding in the urinary tract after CF-LVAD implantation and quantified the impact on hospital resource utilization in comparison with bleeding in the gastrointestinal (GI) tract, the most commonly reported mucosal site of bleeding after LVAD implantation. Records were retrospectively reviewed for patients undergoing CF-LVAD implantation at our institution between October 2011 and April 2015. Major adverse events of gross hematuria and GI bleeding were identified, and patient demographics and hospital course were reviewed. Gross hematuria occurred in 3 of the 35 patients (8.6%) and in 5.1% of all hospitalizations for CF-LVAD patients. Severe hematuria occurred after traumatic urethral catheterization, urinary retention, or urologic surgery. Hospitalization for hematuria was six times less likely than hospitalization for GI bleeding; however, hematuria hospitalizations lasted 3.2 times longer than GI bleeding hospitalizations (17.0 vs. 5.3 days). Late recurrent gross hematuria occurred in all cases, with rehospitalization occurring after 109 ± 53 days. In conclusion, gross hematuria is an infrequent but morbid bleeding complication in CF-LVAD patients. Strategies to avoid this complication include strict avoidance of traumatic urethral catheterization and urinary retention in highrisk patients.

AB - Patients with continuous-flow left ventricular assist devices (CF-LVADs) are at increased risk of bleeding. We reviewed our institutional experience with bleeding in the urinary tract after CF-LVAD implantation and quantified the impact on hospital resource utilization in comparison with bleeding in the gastrointestinal (GI) tract, the most commonly reported mucosal site of bleeding after LVAD implantation. Records were retrospectively reviewed for patients undergoing CF-LVAD implantation at our institution between October 2011 and April 2015. Major adverse events of gross hematuria and GI bleeding were identified, and patient demographics and hospital course were reviewed. Gross hematuria occurred in 3 of the 35 patients (8.6%) and in 5.1% of all hospitalizations for CF-LVAD patients. Severe hematuria occurred after traumatic urethral catheterization, urinary retention, or urologic surgery. Hospitalization for hematuria was six times less likely than hospitalization for GI bleeding; however, hematuria hospitalizations lasted 3.2 times longer than GI bleeding hospitalizations (17.0 vs. 5.3 days). Late recurrent gross hematuria occurred in all cases, with rehospitalization occurring after 109 ± 53 days. In conclusion, gross hematuria is an infrequent but morbid bleeding complication in CF-LVAD patients. Strategies to avoid this complication include strict avoidance of traumatic urethral catheterization and urinary retention in highrisk patients.

KW - bleeding

KW - hematuria

KW - left ventricular assist device

UR - http://www.scopus.com/inward/record.url?scp=84952717942&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84952717942&partnerID=8YFLogxK

U2 - 10.1097/MAT.0000000000000276

DO - 10.1097/MAT.0000000000000276

M3 - Article

C2 - 26461236

AN - SCOPUS:84952717942

VL - 62

SP - e8-e12

JO - ASAIO Journal

JF - ASAIO Journal

SN - 1058-2916

IS - 1

ER -