open access

Vol 27, No 1 (2020)
Review articles — Clinical cardiology
Published online: 2018-07-13
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Aortic stenosis and anemia with an update on approaches to managing angiodysplasia in 2018

Kevin Mohee, Omar Aldalati, Rafal Dworakowski, Hasan Haboubi
DOI: 10.5603/CJ.a2018.0068
·
Pubmed: 30009379
·
Cardiol J 2020;27(1):72-77.

open access

Vol 27, No 1 (2020)
Review articles — Clinical cardiology
Published online: 2018-07-13

Abstract

Angiodyplasia and aortic stenosis are both conditions that are highly prevalent in elderly people and can often co-exist. Recent studies suggest that this association is related to subtle alterations in plasma coagulation factors. The von Willebrand factor is the strongest link between aortic stenosis and bleeding associated with gastrointestinal angiodysplasia. With an ageing population, the disease burden of aortic stenosis and its association with angiodysplasia of the bowel makes this an incredibly underdiagnosed yet important condition. Clinicians should be aware of this association when dealing with elderly patients presenting either with unexplained anemia, gastrointestinal bleeding or with aortic stenosis. A high index of suspicion and appropriate diagnostic techniques followed by appropriate and prompt treatment could be life-saving. No clear guidelines exist on management but surgical aortic valve replacement is thought to offer the best hope for long-term resolution of bleeding. With a growing number of technological armamentarium in the management of such patients, especially with the advent of transcatheter aortic valve implantation, new options can be offered even to elderly patients with comorbidities for whom conventional surgery would have been impossible.

Abstract

Angiodyplasia and aortic stenosis are both conditions that are highly prevalent in elderly people and can often co-exist. Recent studies suggest that this association is related to subtle alterations in plasma coagulation factors. The von Willebrand factor is the strongest link between aortic stenosis and bleeding associated with gastrointestinal angiodysplasia. With an ageing population, the disease burden of aortic stenosis and its association with angiodysplasia of the bowel makes this an incredibly underdiagnosed yet important condition. Clinicians should be aware of this association when dealing with elderly patients presenting either with unexplained anemia, gastrointestinal bleeding or with aortic stenosis. A high index of suspicion and appropriate diagnostic techniques followed by appropriate and prompt treatment could be life-saving. No clear guidelines exist on management but surgical aortic valve replacement is thought to offer the best hope for long-term resolution of bleeding. With a growing number of technological armamentarium in the management of such patients, especially with the advent of transcatheter aortic valve implantation, new options can be offered even to elderly patients with comorbidities for whom conventional surgery would have been impossible.

Get Citation

Keywords

aortic stenosis, Heyde’s syndrome, angiodysplasia, von Willebrand factor, transcatheter aortic valve implantation

About this article
Title

Aortic stenosis and anemia with an update on approaches to managing angiodysplasia in 2018

Journal

Cardiology Journal

Issue

Vol 27, No 1 (2020)

Pages

72-77

Published online

2018-07-13

DOI

10.5603/CJ.a2018.0068

Pubmed

30009379

Bibliographic record

Cardiol J 2020;27(1):72-77.

Keywords

aortic stenosis
Heyde’s syndrome
angiodysplasia
von Willebrand factor
transcatheter aortic valve implantation

Authors

Kevin Mohee
Omar Aldalati
Rafal Dworakowski
Hasan Haboubi

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