Transcatheter aortic valve implantation for acquired von Willebrand syndrome in patients with aortic stenosis

Abstract

In Japan, patients with aortic stenosis (AS) are increasing due to the aging society, and transcatheter aortic valve implantation (TAVI) was introduced in October, 2013. We implemented TAVI in June, 2014, and have currently performed 46 procedures. Acquired von Willebrand syndrome in patients with aortic stenosis, known as Heyde’s syndrome, is not well understood and its prevalence is unknown. Since 1958, there have been 10 cases reported by Dr. Heyde in the New England Journal Medicine magazine. Gastrointestinal bleeding is caused by the deficiency of high-molecular-weight multimers of von Willebrand factor and angiodysplasia. Patients with this syndrome demonstrate complete recovery after aortic valve re placement and recently with TAVI. Here, we report the initial results of 36 TAVI procedures performed at our institution until June 2016, and present the cases of Heyde’s syndrome in which the von Willebrand high-molecular-weight multimer levels were improved by TAVI.