Aortic stenosis and Heyde’s syndrome: A comprehensive review

Table 1 Clinical features of Heyde’s syndrome

Due to	Symptoms	Signs
GI bleed	Hematemesis; Hematochezia; Melena; Abdominal pain	Pallor; Blood on rectal exam; Orthostasis
Aortic stenosis	Dyspnea on exertion; Syncope; Fatigue; Exertional chest pain	Low volume slow rising; carotid pulse; Ejection systolic murmur; Absence of physiologic S2 split
Acquired vWS	Easy bruisability; Mucosal bleeding; Heavy menstrual bleeding	Hemarthosis; Hematoma

GI: Gastrointestinal; vWS: von Willebrand syndrome.

Table 2 Aortic valve replacement in Heyde’s syndrome

Ref.	Year	Type of study	No of patients	Type of aortic valve replacement	Outcome (Positive)	Outcome (negative)
Love et al[13]	1982	Case series	3	Surgical	Complete resolution of GI bleed
Scheffer et al[15]	1986	Case report	1	Surgical-porcine	No GI bleeding during 9 mo follow up
Cappell et al[40]	1986	Case series	2	Surgical	No further bleeding with negative stool guaiac in one pt at 18 mo followup; Disappearance of angiodysplasia by endoscopy with no further bleeding in 2 nd patient at 15 mo follow up
Abi-akar et al[41]	2011	Case report	1	Surgical- bio prosthetic	No bleeding or blood transfusion at 9 mo follow up
Thompson et al[42]	2012	Retrospective review (1971-2001)	57	surgical bioprosthetic(47); mechanical(10)	45 patients (79%) had no recurrence of GI bleeding in 15 year followup	12 patients had persistent GI bleeding post AV replacement
Kadkhodayan et al[43]	2012	Case report	1	TAVR	No further episodes of GI bleeding post discharge
Balbo et al[44]	2016	Case report	1	TAVR	No GI bleeding at 3 and 6 mo of follow up post TAVR
Alshuwaykh et al[45]	2018	Case report	1	TAVR	No further bleeding with stable Hemoglobin at 6 mo follow up	Melena requiring blood transfusion at 2 wk follow up
Garcia et al[46]	2019	Case report	1	Surgical, mechanical	No new episodes of GI bleeding post valve replacemet
Famularo et al[47]	2020	Case report	1	TAVR	No GI bleeding at 3 follow up post TAVR
Godino et al[48]	2012-13	Retrospective (2007-2012)	7	TAVR	During a mean follow-up interval of 22 ± 15 mo, 6 patients (86%) had no recurrence of GI bleeding	One patient had TAVR failure with re hospitalization and blood trasnfusion

GI: Gastrointestinal; TAVR: Transcatheter aortic valve replacement.