Aortic stenosis and unexplained gastro-intestinal haemorrhage. Case reports

Four cases of recurrent gastro-intestinal haemorrhage associated with aortic stenosis are described. Aortic valve replacement was accompanied by a cessation of bleeding in each patient. The source of bleeding was demonstrated or presumed to be from antral or colonic vascular ectasia. It is postulated that the altered pulse wave form in aortic stenosis may contribute towards mucosal ischaemia and ulceration in patients wtih gastro-intestinal angiodysplasia. We recommended that bowel resection be reserved for patients who continue to bleed following aortic valve replacement and who have vascular ectasia on selective mesenteric angiography.