# Heyde’s Syndrome: Presentation and Successful Treatment With Transcatheter Aortic Valve Implantation (TAVI)

## TL;DR

A patient with Heyde’s syndrome was successfully treated with a heart valve implant, resolving both heart and intestinal bleeding issues.

## Contribution

This case demonstrates that TAVI can be an effective treatment for Heyde’s syndrome by addressing the root cause of bleeding.

## Key findings

- TAVI led to stabilization of hemoglobin and resolution of angiodysplasia in a patient with Heyde’s syndrome.
- Correcting aortic stenosis via TAVI resolved the bleeding diathesis caused by shear-stress platelet insult.
- A multidisciplinary approach between cardiology and gastroenterology is crucial for optimal outcomes in Heyde’s syndrome.

## Abstract

Heyde’s syndrome, characterized by the triad of severe aortic stenosis (AS), GI bleeding (GIB) from angiodysplasia, and acquired von Willebrand syndrome, presents a complex diagnostic and therapeutic challenge. We report the case of a male patient in his 70s with recurrent melena and profound anemia requiring multiple transfusions. Extensive initial investigations, including gastroscopy and colonoscopy, failed to identify a bleeding source. The diagnosis was suspected after echocardiography confirmed critical AS and was later confirmed by capsule endoscopy, which revealed bleeding small bowel angiodysplasia. Instead of pursuing direct endoscopic treatment of the angiodysplasia, the decision was made to address the underlying cause with transcatheter aortic valve implantation (TAVI). Following the procedure, the patient’s hemoglobin stabilized, and subsequent enteroscopy confirmed resolution of the angiodysplasia. This case highlights that in patients with AS and obscure GIB, maintaining a high index of suspicion for Heyde’s syndrome is crucial. It demonstrates that timely intervention with TAVI can serve as a definitive treatment by resolving the bleeding diathesis through correction of the shear-stress platelet insult and underscores the importance of a multidisciplinary approach between cardiology and gastroenterology to achieve optimal patient outcomes.