PMC9035938_01
Preoperative images of the multifocal gastric bleeding. a Gastric bleeding at lower body. b Gastric bleeding at middle body. c Gastric bleeding at upper body. d Gastric bleeding near the cardia.
crg-0016-0165-g01.jpg
PMC9035938_01_crg-0016-0165-g01.jpg
F1
On the other hand, esophagogastroduodenoscopy showed multiple sites of gastric bleeding in the lower body (Fig. 1a), middle body (Fig. 1b), upper body (Fig. 1c), and near the cardia (Fig. 1d).
Preoperative images of the gastric bleeding at the less curvature of the lower body and the result of VWF multimer analysis. a Image close to the bleeding point of the less curvature of the lower body. b Image close to the bleeding point on the less curvature of the lower body and irrigation of the blood: no dilated blood vessels were found. c Six seconds after irrigation of the bleeding point: oozing from the mucosal surface is observed, and vascular rupture which cannot be identified by endoscopy is suspected. d The test yielded a normal result; the plasma of the patient did not lack the HMW multimers of VWF.
crg-0016-0165-g02.jpg
PMC9035938_01_crg-0016-0165-g02.jpg
F2
While performing endoscopic imaging near the bleeding point on the less curvature of the lower body of the stomach, irrigation of the blood did not reveal any obvious angiodysplasia (Fig. 2a, b). However, 6 s after irrigation, rebleeding from the seemingly normal gastric mucosa was observed (Fig. 2c). HMW multimers of VWF (Fig. 2d). However, the VWF multimer analysis is not a measurable and quantified laboratory test, and an accurate assessment is difficult.
Postoperative images of the same bleeding sites as before TAVI. a Clear disappearance of gastric bleeding at lower body. b Clear disappearance of gastric bleeding at middle body. c Clear disappearance of gastric bleeding at upper body. d Clear disappearance of gastric bleeding near the cardia.
crg-0016-0165-g03.jpg
PMC9035938_01_crg-0016-0165-g03.jpg
F3
Notably, there was a clear disappearance of gastric bleeding in the lower body (Fig. 3a), middle body (Fig. 3b), upper body (Fig. 3c), and near the cardia (Fig. 3d) 4 months after TAVI.