Rotational thromboelastometry-guided perioperative management of coagulation in a patient with Heyde’s syndrome undergoing transcatheter aortic valve implantation

BACKGROUND: Changes in coagulability during the hyperacute phase within 24 h after transcatheter aortic valve implantation (TAVI) for Heyde’s syndrome, or aortic stenosis complicated by gastrointestinal angiodysplasia and acquired coagulation dysfunction, have not been clarified. We evaluated perioperative changes in coagulability using rotational thromboelastometry (ROTEM). CASE PRESENTATION: A female patient with Heyde’s syndrome in her 80s underwent TAVI. ROTEM showed coagulation dysfunction before and at 6 h after surgery. Improvements in coagulation function started at 12 h after surgery. Based on ROTEM findings, oral administration of antiplatelet agents was started on the day after surgery. No hemorrhagic complications were observed in the postoperative phase. CONCLUSIONS: Evaluation of coagulation function using ROTEM was useful for monitoring perioperative hemostasis and coagulation in this patient.