Recommendations for the Use of Mechanical Circulatory Support: Device Strategies and Patient Selection A Scientific Statement From the American Heart Association

syndrome because of the effect of shear forces on the von Willebrand multimer. 130 This bleeding is typically manifest as mucosal bleeding observed primarily from arteriovenous malforma-tions in the gastrointestinal tract. In 1 study, durable MCS support with a continuous-flow device was associated with 63 transfusion-requiring events per 100 patient-years. 131

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