Jejunal Angiodysplasia in an Elderly Patient with Aortic Stenosis: Significance of Von Willebrand Factor as an Etiologic Factor

Intern Med. 2023 Jul 15;62(14):2059-2062. doi: 10.2169/internalmedicine.0888-22. Epub 2022 Nov 23.

Abstract

Heyde's syndrome is a disease in which patients with aortic stenosis (AS) bleed from angiodysplasia. An 80-year-old woman with a history of severe AS was referred to our hospital with melena and anemia. The patient underwent jejunal resection after repeated blood transfusions. A pathological examination revealed angiodysplasia, and the patient's plasma lacked high-molecular-weight von Willebrand factor (VWF) multimers, leading to the diagnosis of Heyde's syndrome. The patient underwent transcatheter aortic valve implantation (TAVI) one year after the diagnosis, and the VWF index recovered. This is a valuable case in which the pathological analysis of angiodysplasia associated with Heyde's syndrome was possible.

Keywords: Heyde's syndrome; angiodysplasia; aortic stenosis; vascular disease; von Willebrand factor.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiodysplasia* / complications
  • Angiodysplasia* / diagnosis
  • Aortic Valve Stenosis* / complications
  • Aortic Valve Stenosis* / surgery
  • Colonic Diseases* / complications
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Humans
  • Transcatheter Aortic Valve Replacement* / adverse effects
  • von Willebrand Diseases* / complications
  • von Willebrand Diseases* / diagnosis
  • von Willebrand Factor

Substances

  • von Willebrand Factor