| International Session（Panel Discussion）2(JGES・JSGE・JSGS) |
| Sat. November 2nd 14:00 - 17:00 Room 9: Portopia Hotel Main Building Kairaku 3 |
THE ENDOSCOPIC FEATURES OF LOWER GASTROINTESTINAL BLEEDING BEFORE AND AFTER TREATMENT OF SEVERE AORTIC STENOSIS
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| Ken Inoue1, Reo Kobayashi1, Yoshito Itoh1 | |||
| 1Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine | |||
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| BACKGROUND: Most severe aortic stenosis (AS) patients with anemia were found to have gastrointestinal angiodysplasia, which disappeared on treatment with transcatheter aortic valve replacement (TAVR) (N Engl J Med, 2023). We thus evaluated the clinical features of AS-associated gastrointestinal bleeding. METHODS: This was a post-hoc analysis of data collected in a prospective study (UMIN000038948) at our university between 2020 and 2021 involving 50 patients scheduled to undergo TAVR to treat severe-AS with anemia (Hb<11.0g/dL). All enrolled patients underwent a colonoscopy within three months before TAVR. Patients with angiodysplasia at baseline underwent repeat colonoscopy 6-12 months after TAVR. The primary outcomes were the frequency, number of angiodysplasia, and presence of active bleeding, the secondary outcome was their changes after TAVR. RESULTS: Angiodysplasia was detected in 47% of patients (41%, 24%, and 6%) in the colon (right, left, and rectum). The mean number of angiodysplasia per patient before TAVR was 5.8±13.8. Active bleeding was detected in 4% from the right colon. Follow-up endoscopy performed after TAVR in 14 patients revealed a decrease in the mean number of angiodysplasia per patient, from 6.6±7.4 before to 2.7±2.4 after TAVR (p=0.11). No patient experienced active bleeding at the time of follow-up endoscopy. CONCLUSION: Approximately half severe-AS patients with anemia were found to have colonic angiodysplasia, which disappeared on treatment with TAVR. |
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Index Term 1: Angiodsyplasia Index Term 2: Severe aortic stenosis |
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