• Ventricular assist devices (VAD) have become an option as bridge to transplant or destination therapy in many patients (prevalence heart failure in US 5.7 million)
• VADs have significantly improved quality of life by NYHA class & 6 min walk distance 
• 2 main types of VAD exist, pulsatile (PF) and continuous flow (CF), with 98% being CF
• Both bleeding and thrombosis are frequently encountered complications
• Although required systemic anticoagulation increases the risk of bleeding, there is a inherent association between CF VADs and GI AVMs
• Hypotension a common complication, which should be assessed by ruling out: bleeding, thrombosis, mechanical obstruction, sepsis, and RV failure

References

Klein T, Jacob M. Management of Implantable Assisted Circulation Devices. Cardiology Clinics. 2012;30(4):673-682.