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Successful endoscopic clipping for bleeding from colonic angiodysplasia in a case of Heyde syndrome

Nobuyuki Takahashi, Kazuaki Tanabe, Hiroyuki Yoshitomi, Masatake Sato, Jun Kitamura, Hidetoshi Sato, Yutaka Ishibashi, Toshio Shimada, Teiji Oda

Med Sci Monit 2010; 16(9): CS107-109

ID: 881115


Background:    Aortic valve sclerosis, calcification, and stenosis are common in the elderly. Increased life expectancy has resulted in a growing population of elderly people, with a corresponding increase in the number of patients with these degenerative aortic valve diseases.
    Case Report:    We report a case of severe aortic stenosis in an 82-year-old woman with bleeding due to colonic angiodysplasia. The patient presented with anemia unexpectedly before her aortic valve replacement. Colon fiberscopy revealed that colonic angiodysplasia was responsible for the bleeding. The lesion was treated with endoscopic clipping before the successful aortic valve replacement. Additionally, her immunoblot analysis detected a decrease of large molecular weight multimers of von Willebrand factor.
    Conclusions:    The relationship between aortic valve stenosis, acquired von Willebrand disease and gastrointestinal bleeding in elderly patients is known as Heyde syndrome.
        Clinicians should be aware of the possibilities of acquired von Willebrand disease and gastrointestinal bleeding from angiodysplasia in patients with aortic valve stenosis.

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