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J Thorac Cardiovasc Surg 2010;139:e73-e74
© 2010 The American Association for Thoracic Surgery

Brief Clinical Report

Localizing an occult gastrointestinal bleeding by wireless PillCam SB capsule videoendoscopy in a patient with the HeartMate II left ventricular assist device

^a Department for Cardiac and Thoracic Vascular Surgery, University of Lübeck, Lübeck, Germany
^b Department for Internal Medicine, Division I, University of Lübeck, Lübeck, Germany
^c Department of Thoracic and Cardiovascular Surgery, Heart and Diabetes Center, North Rhine Westphalia/University Hospital of Bochum, Bad Öeynhausen, Germany

Received for publication August 13, 2008; accepted for publication August 16, 2008.

^_* Address for reprints: J. F. Matthias Bechtel, MD, University of Lübeck, Department for Cardiac Surgery, Ratzeburger Allee 160, 23538, Lübeck, Germany. (Email: m.bechtel@herzchirurgie-luebeck.de).

The first 20% of the full text of this article appears below.

	Introduction

 
Gastrointestinal bleeding is a known problem in patients with left ventricular assist devices (LVADs). The exact source of the bleeding is sometimes difficult to ascertain. In gastroenterology, wireless capsule videoendoscopy has become an important diagnostic tool, especially when the small intestine is involved. It is not known, however, whether an implanted LVAD would interfere with signal transmission from the capsule, nor whether the signals from the capsule would cause malfunction of the LVAD. We report the case of a patient in whom significant gastrointestinal bleeding developed after implantation of a HeartMate II LVAD (Thoratec Corporation, Pleasanton, Calif). The source of the bleeding was successfully identified by wireless PillCam SB capsule videoendoscopy (Given Imaging Ltd, Yoqneam, Israel).

	Clinical Summary

 
A 70-year-old man had a massive myocardial infarction caused by occlusion of the left main coronary artery. Emergency coronary artery bypass grafting was undertaken. Shock was treated initially with a paracorporal centrifugal pump (Centrimag; Levitronix LLC, Waltham, Mass) and later with an intra-aortic balloon . . . [Full Text of this Article]

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