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Background. Heyde's syndrome implies an association of calcified aortic stenosis with the high gradient of pressure and angiodysplasic bleeding from the digestive tract. It has been proven that in patients with this syndrome, acquired form of von Willebrand type II A develops. Replacing of aortic valves by artificial ones brings about the spontaneous retreat of coagulation disorder, and the stoppage of the digestive tract bleeding. Case report. We reported two patients with the Heyde's syndrome. In one of the patients the aortic valves were replaced by biologic valves, after which the digestive tract bleeding stopped, while the second patient was treated conservatively due to a high operation risk. Conclusion. Patients with Heyde's syndrome are a complex multidisciplinary problem, thus their adequate treatment requires a team work in order to provide the most rational type of therapy for each patient separately. [ABSTRACT FROM AUTHOR]

AIM: Femoral vascular access site complications including: hematoma, retroperitoneal hemorrhage, pseudoaneurysm, arteriovenous fistula (AVF), arterial occlusion, femoral neuropathy and infection. AVF occurs according to literature from 0.2 to 2.1%. The goal was to find out incidence of AVF and their long term consequences. PATIENTS AND METHODS: From January 2008 until November 2013 a total of 6017 coronary angiographies were performed. AVF had 48 patients, respectively 0.7 %. At time of research, 5 patients died and 7 patients did not want to be involved. To the remaining 36 patients, lower extremities venous Doppler and previous AVF site Doppler, as well as echocardiography were performed. RESULTS: From 36 patients with previously diagnosed AVF, 16 patients at the control ultrasound had no visible arteriovenous communication, 20 patients had still open AVF. In group with open fistula 5 patients had no complaints, 15 patients complained of discomfort in the respective leg. Echocardiography in the group of patients with AVF showed only in one patient dilation of right atrium and ventricle. In 3 patients with persistent AVF mild pulmonary hypertension was found, but none in group without AVF. The average pressure in right ventricle measured on tricuspidal regurgitation was significantly higher in a group with AVF, than without (RVSP 22 mmHg; 16 mmHg, p<0.01). There was no significant difference in a systolic function of right ventricle (TAPSE 19mm mm, 21 mm). CONCLUSION: Vascular site complications remain an important cause of increased morbidity, mortality and prolongation of hospital stay. AVF in our hospital occurred in 0.7% patients and 44% of it closed spontaneously. Mostly patients with fistula had local complaints and they had significantly higher right ventricular pressures, but rarely with mild pulmonary hypertension. Clinical monitoring of patients and decision about surgical correction are recommended. [ABSTRACT FROM AUTHOR]