Colonic vascular ectasias and aortic stenosis: Coincidence or causal relationship?

Greenstein, Robert J.; McElhinney, A. James; Reuben, Devaprasad; Greenstein, Adrian J.

doi:10.1016/0002-9610(86)90465-4

Cited by 65 publications

(39 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[1][2][3][4] Supportive therapy is often inadequate to control such episodes, and replacement of the stenotic valve, rather than resection of the affected bowel tract, provides the most effective treatment. 5 In nearly all cases, the largest multimers of plasma von Willebrand factor (vWF) are decreased.…”

mentioning

confidence: 99%

Proteolysis of von Willebrand Factor and Shear Stress–Induced Platelet Aggregation in Patients With Aortic Valve Stenosis

et al. 2000

View full text Add to dashboard Cite

Background-Excessive bleeding may complicate congenital cardiac defects. To explain the pathogenesis of this abnormality, we evaluated selected parameters of primary hemostasis in patients with aortic valve stenosis before and after corrective surgery. Methods and Results-We examined shear-induced platelet aggregation with the filter aggregometer test and von Willebrand factor (vWF) structure by evaluating the multimeric distribution and extent of subunit proteolysis. The platelet count was reduced before corrective surgery, and shear-induced platelet aggregation was impaired. Moreover, vWF multimers of higher molecular mass were decreased, and proteolytic subunit fragments were increased. After correction of the cardiac defect, all of these parameters returned to normal. Conclusions-Alterations of vWF and platelet function may contribute to the bleeding diathesis in patients with aortic valve stenosis. Improvement after corrective surgery suggests that the passage of blood through a stenosed aortic valve may result in shear forces that induce vWF interaction with platelets in the circulation and, in turn, trigger platelet clearance, vWF degradation, and the impairment of primary hemostasis.

show abstract

mentioning

confidence: 99%

Proteolysis of von Willebrand Factor and Shear Stress–Induced Platelet Aggregation in Patients With Aortic Valve Stenosis

et al. 2000

View full text Add to dashboard Cite

show abstract

“…Alguns autores acreditam que nos portadores de estenose aórtica, o desenvolvimento da displasia vascular seria decorrente da menor perfusão sangüínea na parede intestinal, secundária a redução do débito ventricular esquerdo 14 . Outros acreditam que a menor perfusão sangüínea tecidual, decorrente do menor débito cardíaco, não seria suficiente para o desenvolvimento da malformação, mas poderia aumentar o risco de sangramento por provocarem lesão isquêmica ao endotélio vascular de enfermos que já apresentavam previamente a angiodisplasia 9 .…”

Section: Discussionunclassified

Angiodisplasia do ceco na terceira década de vida

Margarido

Consolmagno

Filho

et al. 2007

Rev bras. colo-proctol.

View full text Add to dashboard Cite

RESUMO: As malformações vasculares representam uma das principais causa de hemorragia digestiva baixa em doentes idosos.O acometimento de indivíduos com menos de trinta anos é evento raramente descrito. Objetivo: O objetivo do presente relato é apresentar um caso de angiodisplasia, localizada na região cecal, em doente na terceira década de vida, diagnosticada por meio de arteriografia pré-operatória e confirmada pelo estudo anátomo-patológico. Relato do caso: Homem, 29 anos, com queixa de anemia crônica de origem obscura há vários anos e refratária ao tratamento clínico e transfusional. Com o objetivo de investigar possível origem digestiva foi submetido à arteriografia seletiva abdominal que demonstrou a presença de malformação vascular, localizada na região cecal. Realizou-se colectomia direita onde foi possível confirmar a localização da enfermidade pela arteriografia pós-operatória do espécime extirpado e o diagnóstico definitivo de angiodisplasia pelo estudo anátomo-patológico. Após a intervenção cirúrgica apresentou evolução favorável, estando atualmente no 5º mês pós-operatório sem apresentar sinais de recidiva da anemia. Conclusão: Não obstante à raridade, a possibilidade de angiodisplasia deverá ser sempre considerada na investigação da anemia de causa obscura em doentes jovens.Descritores: Angiodisplasia. Malformações arteriovenosas. Doenças do Ceco. Cirurgia Colorretal. Cólon.

show abstract

“…This is because of damping of arterial pulse wave patterns in the terminal superior mesenteric artery in patients with AS [50,69].…”

Section: Mucosal Ischaemiamentioning

confidence: 99%

“…Reduction in gastrointestinal perfusion pressure [13,18,[64][65][66][67][68] and a redistribution of the splanchnic blood flow in aortic stenosis [50,68,69,35] can cause ischaemia and bleeding due to the loss of bowel mucosal integrity [18]. This is because of damping of arterial pulse wave patterns in the terminal superior mesenteric artery in patients with AS [50,69].…”

Section: Mucosal Ischaemiamentioning

confidence: 99%

Intestinal angiodysplasia and aortic valve stenosis: let's not close the book on this association

Mishra¹,

Kováč²,

Caestecker³

et al. 2009

European Journal of Cardio-Thoracic Surgery

View full text Add to dashboard Cite

SummaryThe association between gastrointestinal (GI) bleeding due to angiodysplasia of the large intestine and calcific aortic stenosis (AS) has been a matter of debate. Recent studies suggest that this association is related to subtle alterations in plasma coagulation factors. von Willebrand factor is the strongest possible link between aortic stenosis and bleeding associated with GI angiodysplasia. Physicians should be aware of this entity when dealing with elderly patients presenting either with GI bleeding or with AS. A high index of suspicion and appropriate diagnostic procedures followed by prompt treatment could be life saving. Several questions related to the pathogenesis and optimal management remain unanswered. Aortic valve replacement appears to offer the best hope of long-term resolution of the bleeding, and should be considered in most cases. The association between chronic gastrointestinal bleeding in elderly patients and aortic stenosis becomes more relevant with the advent of transcatheter aortic valve implantation which can be offered even to elderly patients with comorbidities which could make conventional surgery impossible. #

show abstract

Colonic vascular ectasias and aortic stenosis: Coincidence or causal relationship?

Cited by 65 publications

References 7 publications

Proteolysis of von Willebrand Factor and Shear Stress–Induced Platelet Aggregation in Patients With Aortic Valve Stenosis

Proteolysis of von Willebrand Factor and Shear Stress–Induced Platelet Aggregation in Patients With Aortic Valve Stenosis

Angiodisplasia do ceco na terceira década de vida

Intestinal angiodysplasia and aortic valve stenosis: let's not close the book on this association

Contact Info

Product

Resources

About