Disappearance of angiodysplasia following transcatheter aortic valve implantation in a patient with heyde’s syndrome: A case report and review of the literature

Satoshi Tsuchiya, Yasuharu Matsumoto, Tsuyoshi Doman, Taku Fujiya, Jun Sugisawa, Akira Suda, Koichi Sato, Shohei Ikeda, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Jun Takahashi, Waku Hatta, Tomoyuki Koike, Atsushi Masamune, Yoshikatsu Saiki, Hisanori Horiuchi, Hiroaki Shimokawa

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)271-277
Number of pages7
JournalJournal of atherosclerosis and thrombosis
Volume27
Issue number3
DOIs
Publication statusPublished - 2020 Jan 1

Keywords

  • Aortic stenosis
  • Gastrointestinal angiodysplasia
  • Heyde’s syndrome

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Biochemistry, medical

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