Heyde syndrome: treat aortic valve disease to stop gastrointestinal bleeding?

Heyde syndrome is the association of aortic stenosis and gastrointestinal bleeding (GIB) from angiodysplasia, accompanied by acquired von Willebrand syndrome (aVWS) leading to decreased levels of high molecular weight multimers (HMWMs). The development of angiodysplasia in the gastrointestinal tract remains unclear. Mucosal ischaemia, high shear stress resulting from turbulence caused by the stenotic valve, and the presence of aVWS may be involved. Aortic valve replacement through surgical replacement (SAVR) or transcatheter aortic valve implantation (TAVI) leads to decreased shear stress and may resolve GIB through recovery of aVWS and potentially dissolving angiodysplasias.