Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device

Abstract We herein describe a 49‐year‐old man with severe heart failure due to fulminant myocarditis who underwent left ventricular assist device implantation and received clopidogrel and warfarin as antithrombotic agents. The patient developed anemia secondary to chronic bleeding gastric hyperplast...

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Main Authors: Masahiro Kondo, Tomohiro Nagasue, Takehiro Torisu, Satoshi Miyazono, Yuichi Matsuno, Takahisa Nagahata, Toru Hashimoto, Takeo Fujino, Akira Shiose, Takanari Kitazono
Format: Article
Language:English
Published: Wiley 2024-04-01
Series:DEN Open
Subjects:
Online Access:https://doi.org/10.1002/deo2.369
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author Masahiro Kondo
Tomohiro Nagasue
Takehiro Torisu
Satoshi Miyazono
Yuichi Matsuno
Takahisa Nagahata
Toru Hashimoto
Takeo Fujino
Akira Shiose
Takanari Kitazono
author_facet Masahiro Kondo
Tomohiro Nagasue
Takehiro Torisu
Satoshi Miyazono
Yuichi Matsuno
Takahisa Nagahata
Toru Hashimoto
Takeo Fujino
Akira Shiose
Takanari Kitazono
author_sort Masahiro Kondo
collection DOAJ
description Abstract We herein describe a 49‐year‐old man with severe heart failure due to fulminant myocarditis who underwent left ventricular assist device implantation and received clopidogrel and warfarin as antithrombotic agents. The patient developed anemia secondary to chronic bleeding gastric hyperplastic polyps, necessitating endoscopic mucosal resection. Despite attempts to manage post‐endoscopic mucosal resection bleeding from a gastric ulcer by endoscopic hemostasis using hemostatic forceps, local hemostatic agents, and polyglycolic acid sheets, the bleeding persisted. Hemostasis of the refractory bleeding was finally achieved by endoscopic hand‐suturing of the ulcer. One month later, the ulcer was almost completely scarred. This case has important clinical value in that it demonstrates the efficacy of endoscopic hand‐suturing even in challenging cases such as refractory bleeding gastric ulcers in patients with left ventricular assist devices.
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issn 2692-4609
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publishDate 2024-04-01
publisher Wiley
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series DEN Open
spelling doaj-art-c5f8b468fa3c4ae2b91df8192a5da2302025-08-20T02:55:03ZengWileyDEN Open2692-46092024-04-0141n/an/a10.1002/deo2.369Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist deviceMasahiro Kondo0Tomohiro Nagasue1Takehiro Torisu2Satoshi Miyazono3Yuichi Matsuno4Takahisa Nagahata5Toru Hashimoto6Takeo Fujino7Akira Shiose8Takanari Kitazono9Department of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Cardiovascular Medicine Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Advanced Cardiopulmonary Failure Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Cardiovascular Surgery Graduate School of Medical Sciences Kyushu University Fukuoka JapanDepartment of Medicine and Clinical Science Graduate School of Medical Sciences Kyushu University Fukuoka JapanAbstract We herein describe a 49‐year‐old man with severe heart failure due to fulminant myocarditis who underwent left ventricular assist device implantation and received clopidogrel and warfarin as antithrombotic agents. The patient developed anemia secondary to chronic bleeding gastric hyperplastic polyps, necessitating endoscopic mucosal resection. Despite attempts to manage post‐endoscopic mucosal resection bleeding from a gastric ulcer by endoscopic hemostasis using hemostatic forceps, local hemostatic agents, and polyglycolic acid sheets, the bleeding persisted. Hemostasis of the refractory bleeding was finally achieved by endoscopic hand‐suturing of the ulcer. One month later, the ulcer was almost completely scarred. This case has important clinical value in that it demonstrates the efficacy of endoscopic hand‐suturing even in challenging cases such as refractory bleeding gastric ulcers in patients with left ventricular assist devices.https://doi.org/10.1002/deo2.369endoscopic hand‐suturingendoscopic hemostasisgastric ulcerleft ventricular assist deviceulcer bleeding
spellingShingle Masahiro Kondo
Tomohiro Nagasue
Takehiro Torisu
Satoshi Miyazono
Yuichi Matsuno
Takahisa Nagahata
Toru Hashimoto
Takeo Fujino
Akira Shiose
Takanari Kitazono
Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
DEN Open
endoscopic hand‐suturing
endoscopic hemostasis
gastric ulcer
left ventricular assist device
ulcer bleeding
title Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
title_full Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
title_fullStr Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
title_full_unstemmed Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
title_short Use of endoscopic hand‐suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
title_sort use of endoscopic hand suturing to treat refractory bleeding from a gastric ulcer in a patient with a left ventricular assist device
topic endoscopic hand‐suturing
endoscopic hemostasis
gastric ulcer
left ventricular assist device
ulcer bleeding
url https://doi.org/10.1002/deo2.369
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