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Open Access 01-12-2021 | Transcatheter Aortic Valve Implantation | Original Paper

Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

Authors: Lara Waldschmidt, Andreas Drolz, Paula Heimburg, Alina Goßling, Sebastian Ludwig, Lisa Voigtländer, Matthias Linder, Niklas Schofer, Hermann Reichenspurner, Stefan Blankenberg, Dirk Westermann, Lenard Conradi, Johannes Kluwe, Moritz Seiffert

Published in: Clinical Research in Cardiology | Issue 12/2021

Abstract

Background

Heyde syndrome (HS) is known as the association of severe aortic stenosis (AS) and recurrent gastrointestinal bleeding (GIB) from angiodysplasia. Data on the prevalence of HS and results after TAVI remain scarce.

Methods

2548 consecutive patients who underwent TAVI for the treatment of AS from 2008 to 2017 were evaluated for a history of GIB and the presence of HS. The diagnosis of HS was defined as a clinical triad of severe AS, a history of recurrent GIB, and an endoscopic diagnosis of angiodysplasia. These patients (Heyde) were followed to investigate clinical outcomes, bleeding complications and the recurrence of GIB and were compared to patients with GIB unrelated to HS (Non-Heyde).

Results

A history of GIB prior to TAVI was detected in 190 patients (7.5%). Among them, 47 patients were diagnosed with HS (1.8%). Heyde patients required blood transfusions more frequently compared to Non-Heyde patients during index hospitalization (50.0% vs. 31.9%, p = 0.03). Recurrent GIB was detected in 39.8% of Heyde compared to 21.2% of Non-Heyde patients one year after TAVI (p = 0.03). In patients diagnosed with HS and recurrent GIB after TAVI, the rate of residual ≥ mild paravalvular leakage (PVL) was higher compared to those without recurrent bleeding (73.3% vs. 38.1%, p = 0.05).

Conclusion

A relevant number of patients undergoing TAVI were diagnosed with HS. Recurrent GIB was detected in a significant number of Heyde patients during follow-up. A possible association with residual PVL requires further investigation to improve treatment options and outcomes in patients with HS.

Graphic abstract

Available only for authorised users

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Title: Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation
Authors: Lara Waldschmidt
Andreas Drolz
Paula Heimburg
Alina Goßling
Sebastian Ludwig
Lisa Voigtländer
Matthias Linder
Niklas Schofer
Hermann Reichenspurner
Stefan Blankenberg
Dirk Westermann
Lenard Conradi
Johannes Kluwe
Moritz Seiffert
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Transcatheter Aortic Valve Implantation
Gastrointestinal Bleeding
Aortic Valve Stenosis
Published in: Clinical Research in Cardiology / Issue 12/2021
Print ISSN: 1861-0684
Electronic ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-021-01905-z

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Springer Medicine

Heyde syndrome: prevalence and outcomes in patients undergoing transcatheter aortic valve implantation

Abstract

Background

Methods

Results

Conclusion

Graphic abstract

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Abstract

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Graphic abstract

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