Chinese Medical Sciences Journal ›› 2021, Vol. 36 ›› Issue (4): 307-315.doi: 10.24920/003881

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  1. 1河北医科大学第一医院麻醉科,石家庄 050000
    2福建医科大学附属泉州第一医院麻醉科,泉州 362000
    3中国医学科学院 北京协和医学院,国家心血管病中心 阜外医院麻醉科,北京 100037
  • 收稿日期:2021-01-19 出版日期:2021-12-31 发布日期:2021-10-09
  • 通讯作者: 姚允泰

Aortic Valve Replacement for Patients with Heyde Syndrome: A Literature Review

Huili Li1,Peishuang Lin2,Yuntai Yao3,*()   

  1. 1Department of Anesthesiology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China
    2Department of Anesthesiology, Fujian Medical University Affiliated First Quanzhou Hospital, Quanzhou 362000, China
    3Department of Anesthesiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, China
  • Received:2021-01-19 Published:2021-12-31 Online:2021-10-09
  • Contact: Yuntai Yao


目的 探讨采用主动脉瓣置换术治疗的海德综合征患者的临床特点及结局。
方法 使用检索词“Heyde syndrome”、“gastrointestinal bleeding”、“aortic stenosis”和“surgery”,检索 PubMed、Embase、Ovid、WANFANG、VIP和CNKI等数据库,提取纳入病例报道中的患者生物学特征、主动脉瓣狭窄程度、胃肠道出血部位、手术治疗和预后等临床资料。
结果 纳入的46篇病例报道共包括55例患者,年龄46~87岁。主动脉瓣轻度狭窄1例,中度狭窄1例,重度狭窄42例(余未提及)。胃肠道出血部位分别为结肠(n=8)、空肠(n=6)、回肠(n=4)、盲肠(n=3)、十二指肠(n=3)和多个部位(n=8);未发现特定出血部位的患者为23例。术前血红蛋白水平为43~117 g/L。16例患者接受高分子量von Willebrand 因子检测,结果显示 1例正常,其余病例均下降。在55例患者中,43例接受经胸主动脉瓣置换术,12例接受经导管主动脉瓣置换术;14例完成机械瓣置换,33例完成生物瓣置换。5例患者出现并发症:1例术后出现瓣周漏和消化道出血,并行二次主动脉瓣置换术;2例患者反复出现胃肠道出血。2例分别因急性硬脑膜下血肿和多器官衰竭死亡。在随访期内,其余患者状况良好。
结论 海德综合征是一种以主动脉瓣狭窄和消化道出血为特征的综合征。主动脉瓣置换术是海德综合征的一种有效治疗方法。

关键词: 海德综合征, 胃肠道出血, 主动脉瓣狭窄


Objective To explore the characteristics and clinical outcomes of patients with Heyde syndrome (HS) who undergo aortic valve replacement (AVR).
Methods Electronic databases including PubMed, Embase, Ovid, WANFANG, VIP and CNKI were searched to identify all case reports of HS patients undergoing AVR surgery, using different combinations of search terms “Heyde syndrome”, “gastrointestinal bleeding”, “aortic stenosis”, and “surgery”. Three authors independently extracted the clinical data including the patients’ characteristics, aortic stenosis severity, gastrointestinal bleeding sites, surgical treatments and prognosis.
Results Finally, 46 case reports with 55 patients aging from 46 to 87 years, were determined eligible and included. Of them, 1 patient had mild aortic stenosis, 1 had moderate aortic stenosis, 42 had severe aortic stenosis, and 11 were not mentioned. Gastrointestinal bleeding was detected in colon (n=8), jejunum (n=6), ileum (n=4), cecum (n=3), duodenal (n=3) and multiple sites (n=8). No specific bleeding site was identified in 23 patients. Preoperative hemoglobin level ranged from 43 to 117 g/L. All but one of 16 patients showed decreased level of high molecule weight von Willebrand factor. Of the 55 patients, 43 underwent AVR, and 12 received transcatheter AVR. Aortic valves of 14 cases were replaced by mechanical valves, and 33 cases by biological valves. All patients recovered well during the follow-up, except 5 patients. One patient who had perivalvular leakage and gastrointestinal bleeding after AVR underwent the second AVR. Two patients had recurrent gastrointestinal bleeding. Two patients died of life-threatening acute subdural hematoma and multiple organ failure, respectively.
Conclusions HS is a rare syndrome characterized by aortic stenosis and gastrointestinal bleeding. AVR is an effective treatment for HS.

Key words: Heyde syndrome, gastrointestinal bleeding, aortic valve stenosis

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