Heyde's Syndrome: Therapeutic Strategies and Long-Term Follow-Up

Background: Heyde's syndrome is the association of severe aortic stenosis with episodes of gastrointestinal due to angiodysplastic lesion. Little is known about the factors associated with new episodes of bleeding and long-term outcomes. Furthermore, most data are restricted to case reports and small case series. Objective: To assess the clinical, laboratory and echocardiography profile of patients with Heyde's syndrome who underwent valve intervention or drug therapy. Methods: Prospective cohort of 24 consecutive patients from 2005 to 2018. Clinical, laboratory and echocardiography data were assessed, as well as those related to valve intervention and to outcomes after diagnosis. Statistical significance was set p < 0.05. Results: Half of the 24 patients (50%) presented with bleeding requiring blood transfusion on admission. Angiodysplasias were more frequently found in the ascending colon (62%). Valve intervention (surgical or transcatheter) was performed in 70.8% of the patients, and 29.2% remained on drug therapy. News episodes of bleeding occurred in 25% of the cases, and there was no difference between clinical and intervention groups (28.6 vs 23.5%, p = 1.00; respectively). Mortality at 2-year and 5-year follow-up was 16% and 25%, with no difference between the groups (log-rank p = 0.185 and 0.737, respectively). Conclusions: Patients with Heyde's syndrome had a high rate of bleeding requiring blood transfusion on admission, suggesting that is a severe disease with high mortality risk. No difference was found between the groups subjected to clinical treatment and to valve intervention with regard to rates of rebleeding and late mortality.

Automated summary

Heyde's syndrome patients often require blood transfusion for severe bleeding, indicating a high mortality risk. There was no significant difference in rates of rebleeding and late mortality between the valve intervention and drug therapy groups.