Vanderbilt University Medical Center, Nashville, Tennessee.
Vanderbilt University Medical Center, Nashville, Tennessee; Vanderbilt Heart and Vascular Institute, Nashville, Tennessee.
Am J Cardiol. 2014 Sep 15;114(6):953-4. doi: 10.1016/j.amjcard.2014.06.025. Epub 2014 Jul 2.
The association between aortic valve stenosis and gastrointestinal bleeding, traditionally known as Heyde's syndrome, is the result of a quantitative loss of the highest molecular weight von Willebrand multimers (type 2A von Willebrand syndrome). This results in bleeding from areas of high shear stress such as gastrointestinal angiodysplasias. Correction of this bleeding diathesis after surgical aortic valve replacement has been well described. The effect of transcutaneous aortic valve implantation on Heyde's syndrome has yet to be studied. Herein, we report a patient with severe aortic stenosis, type 2A von Willebrand syndrome, and hemorrhagic shock from gastrointestinal bleeding who underwent successful transcutaneous aortic valve implantation.
主动脉瓣狭窄与胃肠道出血之间的关联，传统上称为 Heyde 综合征，是由于最高分子量 von Willebrand 多聚体（2A 型 von Willebrand 综合征）的定量丢失所致。这会导致高剪切应力区域（如胃肠道血管畸形）出血。主动脉瓣置换术后纠正这种出血素质已有很好的描述。经皮主动脉瓣植入术对 Heyde 综合征的影响尚未得到研究。在此，我们报告了一例严重主动脉瓣狭窄、2A 型 von Willebrand 综合征和胃肠道出血性休克的患者，成功进行了经皮主动脉瓣植入术。
