Published November 17, 2020 | Version v1

Heyde Syndrome: A Case Report and Review of Literature

  • 1. Department of Surgery, Khyber Teaching Hospital Peshawar-Pakistan
  • 2. Department of Stroke, Nevill Hall Hospital Abergavenny, South Wales-UK
  • 3. Department of Pathology, Northwest School of Medicine-Pakistan
  • 4. Department of Medicine, Ayub Teaching Hospital Abbotabad-Pakistan
  • 5. Department of Surgery, Hayatabad Medical Complex Peshawar-Pakistan
  • 6. Khyber Medical College Peshawar-Pakistan

Description

The triad of AV Malformations in the GI tract, Aortic Stenosis and Von Willebrand Disease is known to us as the Heyde Syndrome. We present the case of a 72 years old male patient who presented with Heyde Syndrome Secondary to Aortic Stenosis (Mean gradient of 36) with Proximal Jejunal Arteriovenous malformation- Dieulafoy lesion, seen on Push enteroscopy and capsule endoscopy. The patient had a  porcelain Aorta visible on CT and MRI. A Transcutaneous Aortic Valve Replacement-TAVR was planned to replace the Aortic Valve. Edwardes S3 Prosthetic Size 26 Valve was used. A follow up Echocardiography 3 months after the surgery shows that there is no Aortic Valve stenosis. The patient also underwent a follow up Anterograde Double Balloon Enteroscopy which shows that the AVMs had diminished and are currently non bleeding. The high risk patient with Heyde Syndrome and a Porcelain Aorta recovered with the use of TAVR.

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References

  • 1. Heyde EC. Gastrointestinal bleeding in aortic stenosis. N Engl J Med. 1958; 259: 196.
  • 2. Mishra PK et al. Intestinal angiodysplasia and aortic valve stenosis: lets not close the book on this association. European Journal of Cardiothoracic Surgery 2009; 35: 628-34.
  • 3. King RM, Pluth JR, Guiliani ER. The association of unexplained gastrointestinal bleeding with calcific aortic stenosis. Ann Thorac Surg 1987; 44: 514-6.
  • 4. Tsai HM. Shear stress and von Willebrand factor in health and disease. Semin Thromb Hemost 2003;29:479-488.
  • 5. Vincentelli A, Susen S, Le Tourneau T et al. Acquired von Willebrand syndrome in aortic stenosis. N Engl J Med 2003;349:343-9.