Persistent Gastrointestinal Bleeding after Aortic Valve Replacement in Heyde's Syndrome

Area of Science:

• Gastroenterology
• Hematology
• Cardiology

Background:

• Heyde's syndrome (HS) links aortic stenosis and intestinal angiodysplasias.
• Acquired von Willebrand disease is key in HS pathophysiology, increasing bleeding risk.
• Von Willebrand factor deficiency exacerbates bleeding and anemia in HS patients.

Purpose of the Study:

• To present a case of Heyde's syndrome with von Willebrand deficiency.
• To illustrate the management of lower gastrointestinal bleeding in this context.
• To demonstrate the efficacy of treating angiodysplastic lesions.

Main Methods:

• Case report of an 86-year-old female patient.
• Diagnosis of HS and von Willebrand deficiency.
• Colonoscopy to identify colonic angiodysplasias.
• Argon plasma coagulation for angiodysplastic lesions.

Main Results:

• Patient presented with anemia, elevated INR and aPTT.
• Lower gastrointestinal bleeding occurred during hospitalization.
• Successful treatment of angiodysplastic lesions led to clinical improvement.
• Anemia resolved following intervention.

Conclusions:

• Argon plasma coagulation is effective for managing gastrointestinal bleeding from angiodysplasias in HS.
• Timely intervention can reverse anemia and improve outcomes in HS patients.
• This case underscores the importance of recognizing and treating HS-related complications.