Acute gastrointestinal bleeding following aortic valve replacement in a patient with Heyde's sindrome. Case report.
A 58-year old man was admitted to the hospital because of melena. He had a 1-year history of mechanical aortic valve replacement and coronary stent placement because of myocardial infarction and he was taking warfarin and clopidogrel. Esophagogastroduodenoscopy and colonoscopy were negative for bleeding. Capsule endoscopy showed bleeding diffuse angiodysplasia of the small bowel. The patient was treated with octreotide 20 mg, at monthly interval. After 25 months there had been no recurrence of gastrointestinal bleeding. The case suggests that mechanical valve replacement may not prevent gastrointestinal bleeding in Heyde syndrome and that octreotide treatment should be considered in these cases.
De Palma
G D
GD
Center of Excellence for Surgical Technology Innovation, Department General, Geriatric Surgery and Diangostic, Operative Endoscopy, Faculty of Medicine and Surgery, Federico II University of Naples, Naples, Italy. giovanni.depalma@unina.it
Salvatori
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Masone
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Simeoli
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Rega
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Celiento
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Persico
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D000208:Acute Disease; D016888:Angiodysplasia / Q000188:drug therapy / Q000209:etiology; D000925:Anticoagulants / Q000009:adverse effects; D001021:Aortic Valve / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000601:surgery*; D006471:Gastrointestinal Hemorrhage / Q000188:drug therapy / Q000209:etiology*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D013577:Syndrome
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors