Background Gastrointestinal (GI) bleeding is one of the most common complications after continuous-flow left ventricular assist device implantation. More than one third of patients with incident bleed go on to develop recurrent GI bleeding. Octreotide, a somatostatin analog, is proposed to reduce the risk of recurrent GI bleeding in this population.

Methods and Results This multicenter, retrospective analysis evaluated 51 continuous-flow left ventricular assist device patients who received secondary prophylaxis with octreotide after their index GI bleed from 2009 to 2015. All patients had a hospitalization for GI bleed and received octreotide after discharge. Patient demographics, medical and medication history, and clinical characteristics of patients who rebled after receiving octreotide were compared with non–rebleeders. These data were also compared with matched historical control patients previously enrolled in the HMII (HeartMate II) clinical trials, none of whom received octreotide, to provide a context for the bleeding rates. Twelve patients (24%) who received secondary octreotide prophylaxis developed another GI bleed, whereas 39 (76%) did not. There were similar intergroup demographics; however, significantly more bleeders had a previous GI bleeding history before left ventricular assist device placement (33% versus 5%; P=0.02) and greater frequency of angiodysplasia confirmed during endoscopy (58% versus 23%; P=0.03). Fewer patients in this study experienced a recurrent GI bleed compared with a matched historical control group that did not receive octreotide (24% versus 43%; P=0.04).

Conclusions Patients with continuous-flow left ventricular assist device receiving secondary prophylaxis with octreotide had a significantly lower GI bleed recurrence compared with historical controls not treated with octreotide. Additional prospective studies are needed to confirm these data.

背景胃肠道（GI）出血是连续流左室辅助装置植入后最常见的并发症之一。超过三分之一的事件性出血患者继续出现胃肠道复发性出血。有人建议使用奥曲肽（一种生长抑素类似物）来降低该人群中胃肠道复发性出血的风险。

方法与结果这项多中心回顾性分析评估了51名连续流左心室辅助设备患者，这些患者在2009年至2015年GI指数出血后接受了奥曲肽的二次预防。所有患者均因GI出血住院，出院后接受奥曲肽治疗。将接受奥曲肽治疗后再出血的患者的人口统计学，医学和用药史以及临床特征与未再出血的患者进行比较。这些数据也与先前参加HMII（HeartMate II）临床试验的匹配历史对照患者进行了比较，这些患者均未接受奥曲肽治疗，以提供出血率的背景信息。接受二次奥曲肽预防的12名患者（24％）再次出现了GI出血，而39名患者（76％）则没有。群体间的人口统计也相似；然而，P = 0.02）和在内窥镜检查中证实的血管增生发生率更高（58％比23％；P = 0.03）。与没有接受奥曲肽的匹配的历史对照组相比，本研究中较少的患者经历了复发性GI出血（24％比43％；P = 0.04）。

结论与未用奥曲肽治疗的历史对照相比，接受奥曲肽二次预防的连续流左心室辅助装置患者的胃肠道出血复发率显着降低。需要其他前瞻性研究来确认这些数据。