Anesthesia management of a patient with suspected Heyde syndrome based on medical history and physical findings: Countermeasures against abnormal von Willebrand factor

Abstract

　In Heyde syndrome, acquired von Willebrand disease develops due to aortic stenosis, and coagulation disorder may be problematic in the perioperative period. We report a case in which Heyde syndrome was suspected based on repeated anemia and a history of fecal occult blood immediately before aortic valve replacement. Surgery was performed before obtaining von Willebrand factor (vWF)-related test results. Thus, a dried and concentrated human blood coagulation factor VIII/vWF complex preparation was administered with the aim of preventive supplementation during surgery. Heyde syndrome is not a rare disease and should be suspected in a patient with aortic stenosis with a history of gastrointestinal hemorrhage. In such cases, tests should be performed as early as possible and supplementation of vWF should be considered as needed.