Transcatheter aortic valve implantation for patients with heyde syndrome: A literature review of case reports

Lilan Wang; Kaimin Wu; Weimei Ou; Xin Su; Guangfeng Sun; Weimin Wang; Qiaoru Xu; Bin Wang

doi:10.1016/j.heliyon.2023.e17952

Transcatheter aortic valve implantation for patients with heyde syndrome: A literature review of case reports

Heliyon. 2023 Jul 5;9(7):e17952. doi: 10.1016/j.heliyon.2023.e17952. eCollection 2023 Jul.

Authors

Lilan Wang¹, Kaimin Wu², Weimei Ou², Xin Su², Guangfeng Sun², Weimin Wang¹, Qiaoru Xu¹, Bin Wang^{1

2}

Affiliations

¹ School of Medicine, Xiamen University. Xiamen 361005, China. Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, 361000, China.
² Xiamen Cardiovascular Hospital, Xiamen University, Xiamen, 361000, China.

Abstract

Objective: A systematic review of international case reports of patients with Heyde syndrome (HS) treated by transcatheter aortic valve implantation (TAVI) was conducted to explore the clinical characteristics of this group of patients and sirgical success. Methods: Electronic databases, including PubMed, Embase and CNKI, were searched with combinations of the search terms, Heyde syndrome, gastrointestinal bleeding, aortic stenosis, angiodysplasia and transcatheter aortic valve replacement. All case reports were screened according to inclusion criteria, and HS patient data was summarized.

Results: A total of 31 case reports concerned patients with a history of aortic stenosis and repeated gastrointestinal bleeding. Ultrasonic cardiograms (UCG) were recorded for 27 cases, including those with critical aortic stenosis (n = 26). Gastrointestinal sequelae were reported in 22 cases with duodenal and jejunal being the most common (n = 9). High-molecular-weight multimers of von Willebrand Factor (vWF-HMWM) were measured in 17 cases with the majority being lower (n = 15) and the minority normal (n = 2). All patients experienced recurrent bleeding after medication and endoscopic therapy and symptoms improved after TAVI (31/31). vWF was at normal levels in 11/12 cases post-TAVI. Twenty-five patients were followed up and 22 had no recurrence of symptoms giving an efficacy rate of 88% for TAVI in HS patients.

Conclusions: HS is characterized by angiodysplasia, aortic stenosis and von Willebrand disease with frequent recurrence of bleeding after drug and endoscopic treatment. TAVI is an effective therapy with an 88% resolution rate.

Keywords: Angiodysplasia; Aortic stenosis; Gastrointestinal bleeding; Heyde syndrome; Transcatheter aortic valve replacement.

Publication types

Review