Vitor Emer Egypto Rosa et al. Henrique Barbosa Ribeiro João Ricardo Cordeiro Fernandes Antonio de Santis … Guilherme Sobreira Spina Milena Ribeiro Paixão Lucas José Tachotti Pires Marcelo Bettega Tarso Augusto Duenhas Accorsi Roney Orismar Sampaio Flávio Tarasoutchi
Abstract
Background
Heyde’s syndrome is the association of severe aortic stenosis with episodes of gastrointestinal bleeding due to angiodysplastic lesion. Little is known about the factors associated with new episodes of bleeding and long-term outcomes. Furthermore, most data are restricted to case reports and small case series.
Objective
To assess the clinical, laboratory and echocardiography profile of patients with Heyde’s syndrome who underwent valve intervention or drug therapy.
Methods
Prospective cohort of 24 consecutive patients from 2005 to 2018. Clinical, laboratory and echocardiography data were assessed, as well as those related to valve intervention and outcomes after diagnosis. A P <0.05 was used to indicate statistical significance.
Results
Half of the 24 patients presented with bleeding requiring blood transfusion on admission. Angiodysplasias were more frequently found in the ascending colon (62%). Valve intervention (surgical or transcatheter) was performed in 70.8% of the patients, and 29.2% remained on drug therapy. News episodes of bleeding occurred in 25% of the cases, and there was no difference between clinical and intervention groups (28.6 vs 23.5%, p = 1.00; respectively). Mortality at 2-year and 5-year was 16% and 25%, with no difference between the groups (log-rank p = 0.185 and 0.737, respectively).
Conclusions
Patients with Heyde’s syndrome had a high rate of bleeding requiring blood transfusion on admission, suggesting that it is a severe disease with high mortality risk. No difference was found between clinical and intervention group regarding the rate of rebleeding and late mortality.
