Abstract | OBJECTIVE: METHODS: RESULTS: Fifty-seven patients (39 men and 18 women) were identified. At operation, the median age of patients was 75 years. Intestinal angiodysplasia occurred most commonly in the duodenum and right side of the colon. Before aortic valve replacement, the mean number of bleeding episodes was 12 per patient-year; 48 patients (84%) required blood transfusions. Bioprosthetic valves were used in 47 patients. During follow-up extending to 15 years, 45 patients (79%) had no recurrence of bleeding. In patients who experienced recurrent bleeding, the episodes were reduced from a mean ± standard deviation of 4.7 ± 7 episodes per patient-year to 1.9 ± 2 per patient-year. Recurrent bleeding occurred only in patients with lesions of the duodenum or right colon. Among patients who received bioprostheses, the overall risk of recurrent bleeding was 15%, lower than the 50% risk of subsequent gastrointestinal bleeding with mechanical prostheses. CONCLUSIONS: Aortic valve replacement seems to decrease the risk of gastrointestinal bleeding in patients with Heyde syndrome and is curative in approximately 80%. Although rates of recurrent bleeding were not significantly different between the 2 prosthetic valve types, the higher risk of bleeding in patients receiving warfarin makes bioprosthetic valves the valve of choice for most patients.
|
Authors | Jess L Thompson 3rd, Hartzell V Schaff, Joseph A Dearani, Soon J Park, Thoralf M Sundt 3rd, Rakesh M Suri, Joseph L Blackshear, Richard C Daly |
Journal | The Journal of thoracic and cardiovascular surgery
(J Thorac Cardiovasc Surg)
Vol. 144
Issue 1
Pg. 112-6
(Jul 2012)
ISSN: 1097-685X [Electronic] United States |
PMID | 21864855
(Publication Type: Journal Article)
|
Copyright | Copyright © 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Topics |
- Aged
- Angiodysplasia
(complications)
- Aortic Valve
(surgery)
- Aortic Valve Stenosis
(surgery)
- Female
- Gastrointestinal Hemorrhage
(etiology)
- Heart Valve Prosthesis
(adverse effects)
- Humans
- Logistic Models
- Male
- Proportional Hazards Models
- Recurrence
- Retrospective Studies
- Risk
- Syndrome
|