HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by King, R. M. Articles by Giuliani, E. R. Search for Related Content PubMed PubMed Citation Articles by King, R. M. Articles by Giuliani, E. R.

The Annals of Thoracic Surgery, Vol 44, 514-516, Copyright © 1987 by The Society of Thoracic Surgeons

ARTICLES

The association of unexplained gastrointestinal bleeding with calcific aortic stenosis

RM King, JR Pluth and ER Giuliani
Section of Thoracic and Cardiovascular Surgery, Mayo Clinic, Rochester, MN 55905.

The association of chronic gastrointestinal bleeding and aortic stenosis remains problematical. The cases of 91 patients (age 38 to 80 years) with these disorders who were examined between 1955 and 1975 were reviewed to address this controversy. All patients underwent upper and lower gastrointestinal radiography, small bowel series, and proctoscopy. Other studies were endoscopy in 84 patients, colonoscopy in 61, and visceral angiography in 16. Of the 37 patients who underwent abdominal exploration, 35 (95%) continued to bleed postoperatively, including 8 of 10 patients who had bowel resection for angiodysplasia. Forty patients did not have an abdominal operation, and all have continued to bleed. Sixteen patients (2 of whom had had an abdominal procedure) underwent aortic valve replacement for aortic stenosis. There were 2 intraoperative deaths among these 16 patients. At follow- up, which ranged from 8 to 12 years, only 1 patient who underwent aortic valve replacement had recurrent bleeding secondary to excessive anticoagulation. Thus, overall, gastrointestinal operation was successful in only 5% of patients, but aortic valve replacement was effective in 93%. For unexplained gastrointestinal bleeding associated with aortic stenosis, aortic valve replacement should be considered because of the likelihood of cure.

This article has been cited by other articles:

				K. Yoshida, S. Tobe, and M. Kawata Acquired von Willebrand Disease Type IIA in Patients with Aortic Valve Stenosis. Ann. Thorac. Surg., March 1, 2006; 81(3): 1114 - 1116. [Abstract] [Full Text] [PDF]

				K. Yoshida, S. Tobe, M. Kawata, and M. Yamaguchi Acquired and Reversible von Willebrand Disease With High Shear Stress Aortic Valve Stenosis Ann. Thorac. Surg., February 1, 2006; 81(2): 490 - 494. [Abstract] [Full Text] [PDF]

				F. Hasan, C. S O'Brien, A. Sanyal, and H. R Dalton Aortic stenosis and gastrointestinal bleeding J R Soc Med, February 1, 2004; 97(2): 81 - 82. [Full Text] [PDF]

				P. Batur, W. J. Stewart, and J. H. Isaacson Increased Prevalence of Aortic Stenosis in Patients With Arteriovenous Malformations of the Gastrointestinal Tract in Heyde Syndrome Arch Intern Med, August 11, 2003; 163(15): 1821 - 1824. [Abstract] [Full Text] [PDF]

				A. Vincentelli, S. Susen, T. Le Tourneau, I. Six, O. Fabre, F. Juthier, A. Bauters, C. Decoene, J. Goudemand, A. Prat, et al. Acquired von Willebrand Syndrome in Aortic Stenosis N. Engl. J. Med., July 24, 2003; 349(4): 343 - 349. [Abstract] [Full Text] [PDF]

				F. I. Pareti, A. Lattuada, C. Bressi, M. Zanobini, A. Sala, A. Steffan, and Z. M. Ruggeri Proteolysis of von Willebrand Factor and Shear Stress-Induced Platelet Aggregation in Patients With Aortic Valve Stenosis Circulation, September 12, 2000; 102(11): 1290 - 1295. [Abstract] [Full Text] [PDF]