Síndrome de Heyde: Estratégias Terapêuticas e Seguimento de Longo Prazo

Rosa, Vitor Emer Egypto; Ribeiro, Henrique Barbosa; Fernandes, João Ricardo Cordeiro; Santis, Antonio de; Spina, Guilherme Sobreira; Paixão, Milena Ribeiro; Pires, Lucas José Tachotti; Bettega, Marcelo; Accorsi, Tarso Augusto Duenhas; Sampaio, Roney Orismar; Tarasoutchi, Flávio

doi:10.36660/abc.20200371

Cited by 2 publications

(2 citation statements)

References 20 publications

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“…A small prospective study reported that SAVR also effectively reduces gastrointestinal bleeding in these patients. 37…”

Section: Discussionmentioning

confidence: 99%

“…A small prospective study reported that SAVR also effectively reduces gastrointestinal bleeding in these patients. 37 An evident strength of our study is that our cohort consisted of patients who were part of a prospective registry. 15 The registry captured all AS patients necessitating TAVI since the introduction of the procedure in our center in 2008 and allowed us to have an extended follow-up.…”

Section: Figure 3 Gastrointestinal Bleeding (Gib) Episodes Before And...mentioning

confidence: 99%

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Reduction of Gastrointestinal Bleeding in Patients With Heyde Syndrome Undergoing Transcatheter Aortic Valve Implantation

Goltstein

Rooijakkers

Görtjes

et al. 2022

Circ: Cardiovascular Interventions

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Background: Heyde syndrome is the co-occurrence of aortic stenosis and gastrointestinal bleeding secondary to angiodysplasias. Surgical aortic valve replacement effectively reduces bleeding, but the effects of transcatheter aortic valve implantation (TAVI) are largely unknown. This study aimed to describe the reduction of gastrointestinal bleeding in patients with Heyde syndrome after TAVI and to identify the factors associated with rebleeding. Methods: We enrolled patients with Heyde syndrome from a prospective TAVI registry. Gastrointestinal bleeding episodes were assessed by the Bleeding Academic Research Consortium classification, and cumulative incidence functions were used to calculate cessation rates. Factors potentially associated with rebleeding were analyzed using logistic regression. Differences between Heyde and non-Heyde patients were assessed through a case-cohort study. Results: Between December 2008 and June 2020, 1111 patients underwent TAVI. There were 70 patients with Heyde syndrome (6.3%). In the first year following TAVI, gastrointestinal bleeding ceased in 46 of 70 patients (62% [95% CI, 50%–74%]). Bleeding episodes decreased from 3.2 (95% CI, 2.5–4.2) to 1.6 ([95% CI, 1.2–2.2] P =0.001) and hemoglobin levels increased from 10.3 (95% CI, 10.0–10.8) to 11.3 (95% CI, 10.8–11.6) g/dL ( P =0.007). Between 1 and 5 years after TAVI (35 [interquartile range, 21–51] months), 53 of 62 patients (83% [95% CI, 72%–92%]) no longer experienced gastrointestinal bleeding. Paravalvular leakage (≥mild) was associated with rebleeding risk (odds ratio, 3.65 [95% CI, 1.36–9.80]; P =0.010). Periprocedural bleeding was more common in Heyde than in control patients (adjusted odds ratio, 2.55 [95% CI, 1.37–4.73]; P =0.003). Conclusions: Patients with Heyde syndrome are at increased risk for periprocedural bleeding. Post-TAVI, gastrointestinal bleeding disappears in the majority of patients. Paravalvular leakage may curtail these clinical benefits.

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“…A small prospective study reported that SAVR also effectively reduces gastrointestinal bleeding in these patients. 37…”

Section: Discussionmentioning

confidence: 99%

Section: Figure 3 Gastrointestinal Bleeding (Gib) Episodes Before And...mentioning

confidence: 99%

Reduction of Gastrointestinal Bleeding in Patients With Heyde Syndrome Undergoing Transcatheter Aortic Valve Implantation

Goltstein

Rooijakkers

Görtjes

et al. 2022

Circ: Cardiovascular Interventions

View full text Add to dashboard Cite

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Differential Rates of Lower Gastrointestinal Bleeding and Other Outcomes in Colorectal Cancer Patients With Aortic Stenosis

Khrais¹,

Gilani²,

Sapin³

et al. 2023

Cureus

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Background Aortic stenosis (AS) has been established as a precipitating factor in the development of colonic angiodysplasia, resulting in lower gastrointestinal bleeding (LGIB). While the association between AS and LGIB, termed “Heyde syndrome,” has been examined extensively, few studies assess the impact of comorbid AS on rates of LGIB in patients with colorectal cancer (CRC). Our goal is to examine this association. Methods Patients hospitalized from 2001 to 2013 diagnosed with CRC were identified via ICD-9 codes, further stratified by a diagnosis of AS. Continuous and categorical variables were analyzed by independent sample t-tests and chi-squared analyses respectively. Assessed outcomes included mortality, length of stay (LOS), hospital costs, rates of LGIB, colonic obstruction, colonic perforation, iron-deficiency anemia (IDA), and colectomy. Multivariate analysis via binary logistic regression was utilized to control confounding variables. Results Patients with CRC and AS had higher rates of mortality, lower gastrointestinal bleeding, iron deficiency anemia, and colectomy, while those without AS had higher rates of colonic obstruction. Length of stay and total hospital charges were higher in patients with AS. Discussion CRC outcomes were worse in patients with AS. This could be due to higher rates of LGIB secondary to the prevalence of angiodysplasia among AS patients. More retrospective studies are required to assess the impact of comorbid AS in patients with CRC.

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Síndrome de Heyde: Estratégias Terapêuticas e Seguimento de Longo Prazo

Cited by 2 publications

References 20 publications

Reduction of Gastrointestinal Bleeding in Patients With Heyde Syndrome Undergoing Transcatheter Aortic Valve Implantation

Reduction of Gastrointestinal Bleeding in Patients With Heyde Syndrome Undergoing Transcatheter Aortic Valve Implantation

Differential Rates of Lower Gastrointestinal Bleeding and Other Outcomes in Colorectal Cancer Patients With Aortic Stenosis

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