Disappearance of Angiodysplasia Following Transcatheter Aortic Valve Implantation in a Patient with Heyde's Syndrome: A Case Report and Review of the Literature
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- Tsuchiya Satoshi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Matsumoto Yasuharu
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Doman Tsuyoshi
- Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University
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- Fujiya Taku
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
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- Sugisawa Jun
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Suda Akira
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Sato Koichi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Ikeda Shohei
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Shindo Tomohiko
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Kikuchi Yoku
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Hao Kiyotaka
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Takahashi Jun
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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- Hatta Waku
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
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- Koike Tomoyuki
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
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- Masamune Atsushi
- Department of Gastroenterology, Tohoku University Graduate School of Medicine
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- Saiki Yoshikatsu
- Department of Cardiovascular Surgery, Tohoku University Graduate school of Medicine
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- Horiuchi Hisanori
- Department of Molecular and Cellular Biology, Institute of Development, Aging, and Cancer, Tohoku University
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- Shimokawa Hiroaki
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine
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Abstract
<p>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.</p><p>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.</p><p>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.</p>
Journal
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- Journal of Atherosclerosis and Thrombosis
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Journal of Atherosclerosis and Thrombosis 27 (3), 271-277, 2020-03-01
Japan Atherosclerosis Society
