A case of Heyde syndrome: resolution following aortic valve replacement.

Heyde syndrome is a triad of aortic stenosis, acquired coagulopathy, and anemia due to bleeding from intestinal angiodysplasia. Here we describe a case of this syndrome. An 80-year-old woman with severe aortic stenosis was referred to our department for an aortic valve replacement. She suffered from recurrent iron-deficiency anemia and required transfusions every 2 weeks. Gastroscopy and colonoscopy were normal with the exception of angiodysplasia without bleeding in the cecum. After aortic valve replacement her anemia was resolved. She was discharged on postoperative day 22. No transfusions were needed after the procedure. To date, her hemoglobin has remained stable at >10 mg/dL.

Use of autologous platelet-rich clots for the prevention of local injury bleeding in patients with severe inherited mucocutaneous bleeding disorders.

Stopping or preventing local bleeding in patients with inherited bleeding disorders linked to abnormal platelet function is traditionally treated by transfusion of blood cell products or recombinant factor VIIa. We now report the use in such patients of autologous platelet-rich clots as an aid to preventing bleeding and to facilitating tissue regeneration at superficial sites. Two patients with von Willebrand's disease (VWD) type 2B and one patient with type I Glanzmann thrombasthenia were treated after tooth extraction and dental surgery. A fourth patient with platelet-type VWD underwent a skin biopsy. Whereas all four patients had a lifelong history of bleeding complications, the application of an autologous platelet-rich clot immediately after surgery combined with tranexamic acid intake to slow fibrinolysis prevented blood loss and resulted in rapid and normal healing. This new procedure is simple, safe and inexpensive; it provides extra security for patients with a bleeding risk undergoing dentistry or superficial surgery.