与主动脉瓣狭窄相关的胃肠道出血（海德综合征）：病例系列及文献综述
Gastrointestinal bleeding associated to aortic valve stenosis (Heyde's syndrome): a case series and literature review.
作者信息
De Carlini Caterina Chiara, Cantù Edoardo, Erba Nicoletta, Maggiolini Stefano
机构信息
Cardiology Division, Cardiovascular Department, S.PIO XI Hospital, Largo Mazzini 1, 20832 Desio (MB), Italy.
Cardiology Division, Cardiovascular Department, San L. Mandic Hospital, Merate (Lc), Italy.
出版信息
Eur Heart J Case Rep. 2023 Aug 18;7(8):ytad412. doi: 10.1093/ehjcr/ytad412. eCollection 2023 Aug.
BACKGROUND
The association among aortic valve stenosis, gastrointestinal bleeding, and anaemia due to arteriovenous malformations, known as Heyde's syndrome (HS), is poorly understood and controversial. Recently, acquired Type 2A von Willebrand syndrome (vWS 2A) was shown to be the most likely aetiological mechanism of anaemia.
CASE SUMMARY
We report two cases of HS in whom the percutaneous replacement of the aortic valve was resolutive for iron deficiency anaemia.
DISCUSSION
Iron deficiency anaemia and aortic stenosis are a common association in the elderly, so much that frequently; in such cases, the correction of the valvulopathy is often excluded as pre-operative anaemia is associated with higher morbidity and mortality. From this perspective, the correct diagnosis of HS is crucial to guide the decision to correct valvulopathy, as valvular substitution is resolutive for both anaemic disorders and aortic stenosis.
背景
主动脉瓣狭窄、胃肠道出血和动静脉畸形所致贫血之间的关联，即所谓的海德综合征（HS），目前了解甚少且存在争议。最近研究表明，获得性2A型血管性血友病综合征（vWS 2A）最有可能是贫血的病因机制。
病例摘要
我们报告了两例HS病例，其中经皮主动脉瓣置换术对缺铁性贫血具有治疗作用。
讨论
缺铁性贫血和主动脉狭窄在老年人中较为常见，以至于在这类病例中，由于术前贫血与更高的发病率和死亡率相关，瓣膜病变的纠正常常被排除在外。从这个角度来看，HS的正确诊断对于指导瓣膜病变纠正的决策至关重要，因为瓣膜置换术对贫血症和主动脉狭窄均有治疗作用。
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