Heyde's Syndrome and Transcatheter Aortic Valve Implantation

Balbo, Conrado; Seabra, Luciana Paula; Galoro, Victor Gualda; Caputi, Guido; Palma, José Honório; Buffolo, Ênio

doi:10.5935/abc.20160193

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…A normalization of hemostasis parameters including vWF was reported after TAVI, especially in those with pre-existing aVWS [4,8]. Few small studies and case series reported no recurrence of GIB in patients with HS after TAVI, albeit limited due to short-term follow-up and small patient numbers [3,4,8,[13][14][15]. In contrast to these earlier publications, we observed that a substantial number of Heyde patients suffered from recurrent GIB after TAVI already during 1-year follow-up despite adequate treatment of AS.…”

Section: Discussionmentioning

confidence: 99%

“…Since transcatheter aortic valve implantation (TAVI) has become the preferred treatment in the majority of patients with severe AS, it remains to be determined whether TAVI would likewise resolve recurrent GIB in patients with HS. First reports suggested a resolution of bleeding but these assumptions were drawn from small analyses including only few Heyde patients or case reports and evidence overall remains scarce [3,4,8,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

et al. 2021

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Background Heyde syndrome (HS) is known as the association of severe aortic stenosis (AS) and recurrent gastrointestinal bleeding (GIB) from angiodysplasia. Data on the prevalence of HS and results after TAVI remain scarce. Methods 2548 consecutive patients who underwent TAVI for the treatment of AS from 2008 to 2017 were evaluated for a history of GIB and the presence of HS. The diagnosis of HS was defined as a clinical triad of severe AS, a history of recurrent GIB, and an endoscopic diagnosis of angiodysplasia. These patients (Heyde) were followed to investigate clinical outcomes, bleeding complications and the recurrence of GIB and were compared to patients with GIB unrelated to HS (Non-Heyde). Results A history of GIB prior to TAVI was detected in 190 patients (7.5%). Among them, 47 patients were diagnosed with HS (1.8%). Heyde patients required blood transfusions more frequently compared to Non-Heyde patients during index hospitalization (50.0% vs. 31.9%, p = 0.03). Recurrent GIB was detected in 39.8% of Heyde compared to 21.2% of Non-Heyde patients one year after TAVI (p = 0.03). In patients diagnosed with HS and recurrent GIB after TAVI, the rate of residual ≥ mild paravalvular leakage (PVL) was higher compared to those without recurrent bleeding (73.3% vs. 38.1%, p = 0.05). Conclusion A relevant number of patients undergoing TAVI were diagnosed with HS. Recurrent GIB was detected in a significant number of Heyde patients during follow-up. A possible association with residual PVL requires further investigation to improve treatment options and outcomes in patients with HS. Graphic abstract

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

et al. 2021

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“…It reduces the mechanical shear stress on the HMW vWF multimers inhibiting their cleavage by ADAMTS13 and consequently improves coagulation abnormalities implicated in Heyde's syndrome. There are several observational studies that have demonstrated potential therapeutic benefits of AVR [45][46][47][48][49][50][51][52][53]. All studies were published between 2010 and 2020; cessation of gastrointestinal bleeding following AVR was the most measured outcome.…”

Section: Aortic Valve Replacementmentioning

confidence: 99%

Reappraising the spectrum of bleeding gastrointestinal angioectasia in a degenerative calcific aortic valve stenosis: Heyde’s syndrome

2021

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Background The occurrence of bleeding gastrointestinal angioectasia in elderly patients with degenerative calcific aortic stenosis is one of the most challenging clinical scenarios. A number of studies have shown that this clinical phenomenon is known as Heyde’s syndrome. Main body of the abstract The pathogenesis of Heyde’s syndrome is mainly due to the loss of high-molecular-weight von Willebrand factor (HMW vWF) multimers, as a consequent fragmentation of HMW vWF multimers as they pass through the stenosed aortic valve leading to acquired von Willebrand syndrome type IIA. Aortic valve replacement has proven to be a more effective management approach in the cessation of recurrent episodes of gastrointestinal bleeding. Short conclusion Physicians should have a high index of suspicion when dealing with elderly patients with established aortic stenosis presenting with iron deficiency anemia or unclear gastrointestinal bleeding. Parallel consultations between different specialties are essential for appropriate management.

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“…В такой клинической ситуации открытая операция с использованием искусственного кровообращения может сопровождаться высоким риском периоперационной летальности [32]. В подобных случаях возможно успешное применение транскатертерного протезирования аортального клапана [33,34].…”

Section: лечение кровотечений обусловленных синдромом хейдаunclassified

Heyde’s syndrome as a rare cause of gastrointestinal bleeding in aortic stenosis patients

Белов¹,

Garbuzenko²,

Лукин³

et al. 2021

Cardiovasc Ther Prev

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ФГБУ Федеральный центр сердечно-сосудистой хирургии. Челябинск; 2 ФГБОУ ВО "Южно-Уральский государственный медицинский университет" Министерства здравоохранения Российской Федерации. Челябинск, РоссияОдна из причин желудочно-кишечных кровотечений у больных с патологией сердца -синдром Хейда. Он характеризуется приобретенным разрушением высокомолекулярных мультимеров фактора фон Виллебранда вследствие высокого гидравлического напряжения сдвига на аортальном клапане при его тяжелом стенозе, с последующим развитием кровотечений из ангиодисплазий желудочно-кишечного тракта. Оптимальное ведение страдающих им пациентов представляет сложную и актуальную проблему. Основным патогенетически обоснованным методом лечения синдрома Хейда является протезирование аортального клапана, что позволяет уменьшить риск рецидива желудочно-кишечных кровотечений более чем у 90% больных. Ключевые слова: синдром Хейда, аортальный стеноз, желудочнокишечные кровотечения.Отношения и деятельность: нет.

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Heyde's Syndrome and Transcatheter Aortic Valve Implantation

Cited by 10 publications

References 8 publications

Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

Reappraising the spectrum of bleeding gastrointestinal angioectasia in a degenerative calcific aortic valve stenosis: Heyde’s syndrome

Heyde’s syndrome as a rare cause of gastrointestinal bleeding in aortic stenosis patients

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