Gastrointestinal Angiodysplasia before and after TAVR

To the Editor: In the letter by Yashige et al. (Oct. 19 issue),(1) the therapeutic role of transcatheter aortic-valve replacement (TAVR) in patients with anemia caused by gastrointestinal angiodysplasia is reported. It is interesting to read that the number and size of the angiodysplastic lesions in these patients were reduced after TAVR, with no further active bleeding detected. The relationship between angiodysplasia and aortic stenosis has been documented.(2) Moreover, in patients with "asymptomatic" severe aortic stenosis, anemia has substantial effects on long-term outcomes.(3) In the current North American and European guidelines, elective aortic-valve replacement in asymptomatic patients is recommended only . . .