Tags

Type your tag names separated by a space and hit enter

Life-threatening subdural hematoma after aortic valve replacement in a patient with Heyde syndrome: a case report.
J Cardiothorac Surg 2017; 12(1):65JC

Abstract

BACKGROUND

Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding. On the other hand, intracranial hemorrhage complicating Heyde syndrome is extremely rare.

CASE PRESENTATION

A 77-year-old woman presented to our hospital with severe aortic stenosis and severe anemia due to gastrointestinal bleeding and was diagnosed with Heyde syndrome. Although aortic valve replacement was performed without recurrent gastrointestinal bleeding, postoperative life-threatening acute subdural hematoma occurred with a marked midline shift. Despite prompt surgical evacuation of the hematoma, she did not recover consciousness and she died 1 month after the operation.

CONCLUSIONS

Postoperative subdural hematoma is rare, but it should be kept in mind as a devastating hemorrhagic complication, especially in patients with Heyde syndrome.

Authors+Show Affiliations

Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan. t-uchida@med.id.yamagata-u.ac.jp.Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.Second Department of Surgery, Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

28789675

Citation

Uchida, Tetsuro, et al. "Life-threatening Subdural Hematoma After Aortic Valve Replacement in a Patient With Heyde Syndrome: a Case Report." Journal of Cardiothoracic Surgery, vol. 12, no. 1, 2017, p. 65.
Uchida T, Hamasaki A, Ohba E, et al. Life-threatening subdural hematoma after aortic valve replacement in a patient with Heyde syndrome: a case report. J Cardiothorac Surg. 2017;12(1):65.
Uchida, T., Hamasaki, A., Ohba, E., Yamashita, A., Hayashi, J., & Sadahiro, M. (2017). Life-threatening subdural hematoma after aortic valve replacement in a patient with Heyde syndrome: a case report. Journal of Cardiothoracic Surgery, 12(1), p. 65. doi:10.1186/s13019-017-0629-x.
Uchida T, et al. Life-threatening Subdural Hematoma After Aortic Valve Replacement in a Patient With Heyde Syndrome: a Case Report. J Cardiothorac Surg. 2017 Aug 8;12(1):65. PubMed PMID: 28789675.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Life-threatening subdural hematoma after aortic valve replacement in a patient with Heyde syndrome: a case report. AU - Uchida,Tetsuro, AU - Hamasaki,Azumi, AU - Ohba,Eiichi, AU - Yamashita,Atsushi, AU - Hayashi,Jun, AU - Sadahiro,Mitsuaki, Y1 - 2017/08/08/ PY - 2017/04/06/received PY - 2017/08/02/accepted PY - 2017/8/10/entrez PY - 2017/8/10/pubmed PY - 2017/11/29/medline KW - Aortic valve replacement KW - Case report KW - Heyde syndrome KW - Subdural hematoma SP - 65 EP - 65 JF - Journal of cardiothoracic surgery JO - J Cardiothorac Surg VL - 12 IS - 1 N2 - BACKGROUND: Heyde syndrome is known as a triad of calcific aortic stenosis, anemia due to gastrointestinal bleeding from angiodysplasia, and acquired type 2A von Willebrand disease. This acquired hemorrhagic disorder is characterized by the loss of the large von Willebrand factor multimers due to the shear stress across the diseased aortic valve. The most frequently observed type of bleeding in these patients is mucosal or skin bleeding, such as epistaxis, followed by gastrointestinal bleeding. On the other hand, intracranial hemorrhage complicating Heyde syndrome is extremely rare. CASE PRESENTATION: A 77-year-old woman presented to our hospital with severe aortic stenosis and severe anemia due to gastrointestinal bleeding and was diagnosed with Heyde syndrome. Although aortic valve replacement was performed without recurrent gastrointestinal bleeding, postoperative life-threatening acute subdural hematoma occurred with a marked midline shift. Despite prompt surgical evacuation of the hematoma, she did not recover consciousness and she died 1 month after the operation. CONCLUSIONS: Postoperative subdural hematoma is rare, but it should be kept in mind as a devastating hemorrhagic complication, especially in patients with Heyde syndrome. SN - 1749-8090 UR - https://www.unboundmedicine.com/medline/citation/28789675/Life_threatening_subdural_hematoma_after_aortic_valve_replacement_in_a_patient_with_Heyde_syndrome:_a_case_report_ L2 - https://cardiothoracicsurgery.biomedcentral.com/articles/10.1186/s13019-017-0629-x DB - PRIME DP - Unbound Medicine ER -