Disappearance of Angiodysplasia Following Transcatheter Aortic Valve Implantation in a Patient with Heyde's Syndrome: A Case Report and Review of the Literature.


Journal

Journal of atherosclerosis and thrombosis
ISSN: 1880-3873
Titre abrégé: J Atheroscler Thromb
Pays: Japan
ID NLM: 9506298

Informations de publication

Date de publication:
01 Mar 2020
Historique:
pubmed: 6 8 2019
medline: 18 12 2020
entrez: 6 8 2019
Statut: ppublish

Résumé

An 83-year-old woman with severe aortic stenosis was admitted to our hospital due to heart failure with refractory anemia requiring blood transfusions. She had repetitive bleeding episodes from endoscopically proven angiodysplasia in the stomach. Moreover, she repeatedly underwent endoscopic argon plasma coagulation for hemostasis. Importantly, she had a deficiency of the high-molecular-weight (HMW) multimers of von Willebrand factor (VWF), and she was diagnosed with Heyde's syndrome.After she underwent transcatheter aortic valve implantation (TAVI), aortic valve area and mean left ventricular aorta pressure gradient improved. Notably, endoscopy showed cessation of bleeding at 10 days after TAVI and the disappearance of angiodysplasia at 4 months after TAVI. Even at 2 years after TAVI, follow-up endoscopy showed remaining free of angiodysplasia in the stomach. She experienced no episodes of anemia since TAVI procedure. Additionally, analysis of HMW multimers demonstrated immediate and lasting recovery after TAVI.Recovery of HMW multimers of VWF with cessation of gastrointestinal bleeding following aortic valve replacement has been previously reported in a patient diagnosed with Heyde's syndrome. To the best our knowledge, this is the first case to demonstrate that angiodysplasia disappears after TAVI for a long term with endoscopic images in a patient with Heyde's syndrome. Here, we summarized case reports of patients with Heyde's syndrome that required aortic valve intervention. Cessation of gastrointestinal bleeding and anemia after aortic valve intervention for severe aortic stenosis may be attributed not only to recovery of HMW multimers of VWF but also to the disappearance of angiodysplasia.

Identifiants

pubmed: 31378751
doi: 10.5551/jat.49239
pmc: PMC7113142
doi:

Substances chimiques

von Willebrand Factor 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

271-277

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Auteurs

Satoshi Tsuchiya (S)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Yasuharu Matsumoto (Y)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Tsuyoshi Doman (T)

Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University.

Taku Fujiya (T)

Department of Gastroenterology, Tohoku University Graduate School of Medicine.

Jun Sugisawa (J)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Akira Suda (A)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Koichi Sato (K)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Shohei Ikeda (S)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Tomohiko Shindo (T)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Yoku Kikuchi (Y)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Kiyotaka Hao (K)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Jun Takahashi (J)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

Waku Hatta (W)

Department of Gastroenterology, Tohoku University Graduate School of Medicine.

Tomoyuki Koike (T)

Department of Gastroenterology, Tohoku University Graduate School of Medicine.

Atsushi Masamune (A)

Department of Gastroenterology, Tohoku University Graduate School of Medicine.

Yoshikatsu Saiki (Y)

Department of Cardiovascular Surgery, Tohoku University Graduate school of Medicine.

Hisanori Horiuchi (H)

Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University.

Hiroaki Shimokawa (H)

Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine.

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