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Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis

AIMS: Heyde syndrome is the co-occurrence of aortic stenosis, acquired von Willebrand syndrome, and gastrointestinal bleeding. Aortic valve replacement has been demonstrated to resolve all three associated disorders. A systematic review and meta-analysis were performed to obtain best estimates of th...

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Autores principales: Goltstein, Lia C M J, Rooijakkers, Maxim J P, Hoeks, Marlijn, Li, Wilson W L, van Wely, Marleen H, Rodwell, Laura, van Royen, Niels, Drenth, Joost P H, van Geenen, Erwin-Jan M
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471563/
https://www.ncbi.nlm.nih.gov/pubmed/37555393
http://dx.doi.org/10.1093/eurheartj/ehad340
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author Goltstein, Lia C M J
Rooijakkers, Maxim J P
Hoeks, Marlijn
Li, Wilson W L
van Wely, Marleen H
Rodwell, Laura
van Royen, Niels
Drenth, Joost P H
van Geenen, Erwin-Jan M
author_facet Goltstein, Lia C M J
Rooijakkers, Maxim J P
Hoeks, Marlijn
Li, Wilson W L
van Wely, Marleen H
Rodwell, Laura
van Royen, Niels
Drenth, Joost P H
van Geenen, Erwin-Jan M
author_sort Goltstein, Lia C M J
collection PubMed
description AIMS: Heyde syndrome is the co-occurrence of aortic stenosis, acquired von Willebrand syndrome, and gastrointestinal bleeding. Aortic valve replacement has been demonstrated to resolve all three associated disorders. A systematic review and meta-analysis were performed to obtain best estimates of the effect of aortic valve replacement on acquired von Willebrand syndrome and gastrointestinal bleeding. METHODS AND RESULTS: A literature search was performed to identify articles on Heyde syndrome and aortic valve replacement up to 25 October 2022. Primary outcomes were the proportion of patients with recovery of acquired von Willebrand syndrome within 24 h (T1), 24–72 h (T2), 3–21 days (T3), and 4 weeks to 2 years (T4) after aortic valve replacement and the proportion of patients with cessation of gastrointestinal bleeding. Pooled proportions and risk ratios were calculated using random-effects models. Thirty-three studies (32 observational studies and one randomized controlled trial) on acquired von Willebrand syndrome (n = 1054), and 11 observational studies on gastrointestinal bleeding (n = 300) were identified. One study reported on both associated disorders (n = 6). The pooled proportion of Heyde patients with acquired von Willebrand syndrome recovery was 86% (95% CI, 79%–91%) at T1, 90% (74%–96%) at T2, 92% (84%–96%) at T3, and 87% (67%–96%) at T4. The pooled proportion of Heyde patients with gastrointestinal bleeding cessation was 73% (62%–81%). Residual aortic valve disease was associated with lower recovery rates of acquired von Willebrand syndrome (RR 0.20; 0.05–0.72; P = 0.014) and gastrointestinal bleeding (RR 0.57; 0.40–0.81; P = 0.002). CONCLUSION: Aortic valve replacement is associated with rapid recovery of the bleeding diathesis in Heyde syndrome and gastrointestinal bleeding cessation. Residual valve disease compromises clinical benefits.
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spelling pubmed-104715632023-09-02 Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis Goltstein, Lia C M J Rooijakkers, Maxim J P Hoeks, Marlijn Li, Wilson W L van Wely, Marleen H Rodwell, Laura van Royen, Niels Drenth, Joost P H van Geenen, Erwin-Jan M Eur Heart J Meta-Analysis AIMS: Heyde syndrome is the co-occurrence of aortic stenosis, acquired von Willebrand syndrome, and gastrointestinal bleeding. Aortic valve replacement has been demonstrated to resolve all three associated disorders. A systematic review and meta-analysis were performed to obtain best estimates of the effect of aortic valve replacement on acquired von Willebrand syndrome and gastrointestinal bleeding. METHODS AND RESULTS: A literature search was performed to identify articles on Heyde syndrome and aortic valve replacement up to 25 October 2022. Primary outcomes were the proportion of patients with recovery of acquired von Willebrand syndrome within 24 h (T1), 24–72 h (T2), 3–21 days (T3), and 4 weeks to 2 years (T4) after aortic valve replacement and the proportion of patients with cessation of gastrointestinal bleeding. Pooled proportions and risk ratios were calculated using random-effects models. Thirty-three studies (32 observational studies and one randomized controlled trial) on acquired von Willebrand syndrome (n = 1054), and 11 observational studies on gastrointestinal bleeding (n = 300) were identified. One study reported on both associated disorders (n = 6). The pooled proportion of Heyde patients with acquired von Willebrand syndrome recovery was 86% (95% CI, 79%–91%) at T1, 90% (74%–96%) at T2, 92% (84%–96%) at T3, and 87% (67%–96%) at T4. The pooled proportion of Heyde patients with gastrointestinal bleeding cessation was 73% (62%–81%). Residual aortic valve disease was associated with lower recovery rates of acquired von Willebrand syndrome (RR 0.20; 0.05–0.72; P = 0.014) and gastrointestinal bleeding (RR 0.57; 0.40–0.81; P = 0.002). CONCLUSION: Aortic valve replacement is associated with rapid recovery of the bleeding diathesis in Heyde syndrome and gastrointestinal bleeding cessation. Residual valve disease compromises clinical benefits. Oxford University Press 2023-07-05 /pmc/articles/PMC10471563/ /pubmed/37555393 http://dx.doi.org/10.1093/eurheartj/ehad340 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Meta-Analysis
Goltstein, Lia C M J
Rooijakkers, Maxim J P
Hoeks, Marlijn
Li, Wilson W L
van Wely, Marleen H
Rodwell, Laura
van Royen, Niels
Drenth, Joost P H
van Geenen, Erwin-Jan M
Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title_full Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title_fullStr Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title_full_unstemmed Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title_short Effectiveness of aortic valve replacement in Heyde syndrome: a meta-analysis
title_sort effectiveness of aortic valve replacement in heyde syndrome: a meta-analysis
topic Meta-Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10471563/
https://www.ncbi.nlm.nih.gov/pubmed/37555393
http://dx.doi.org/10.1093/eurheartj/ehad340
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