scholarly journals TCT-781 Patients With Von Willebrand Factor Abnormalities Bleed Less Frequently After Transcatheter Than Surgical Aortic Valve Replacement

2018 ◽  
Vol 72 (13) ◽  
pp. B311-B312
Author(s):  
Kajetan Grodecki ◽  
Karol Zbroński ◽  
Bartosz Rymuza ◽  
Anna Olasińska-Wiśniewska ◽  
Piotr Scisło ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Von Willebrand Factor ◽  
Surgical Aortic Valve Replacement ◽  
Von Willebrand ◽  
Willebrand Factor

scholarly journals Von Willebrand Factor Multimers during Transcatheter Aortic-Valve Replacement

2016 ◽  
Vol 375 (4) ◽  
pp. 335-344 ◽  
Author(s):  
Eric Van Belle ◽  
Antoine Rauch ◽  
Flavien Vincent ◽  
Emmanuel Robin ◽  
Marion Kibler ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Von Willebrand Factor ◽  
Transcatheter Aortic Valve Replacement ◽  
Transcatheter Aortic Valve ◽  
Von Willebrand ◽  
Willebrand Factor

Alteration of von Willebrand Factor after Transcatheter Aortic Valve Replacement in the Absence of Paravalvular Regurgitation

2018 ◽  
Vol 118 (01) ◽  
pp. 103-111 ◽  
Author(s):  
Felix Pawlitschek ◽  
Cornelius Keyl ◽  
Barbara Zieger ◽  
Ulrich Budde ◽  
Friedhelm Beyersdorf ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Von Willebrand Factor ◽  
Binding Capacity ◽  
Prosthetic Heart Valve ◽  
Collagen Binding ◽  
Transcatheter Aortic Valve ◽  
Von Willebrand ◽  
Willebrand Factor

AbstractModerate or severe paravalvular regurgitation after transcatheter aortic valve implantation (TAVI) is frequently associated with a loss of high-molecular-weight multimers of von Willebrand factor (VWF) and a reduced VWF collagen-binding capacity. It is unclear whether this phenomenon can also be observed in patients with mild paravalvular regurgitation, and whether there are differences between patients undergoing conventional aortic valve replacement (AVR) or TAVI. We analysed the multimeric structure of VWF and the ratio of VWF collagen-binding capacity to VWF antigen pre- and postoperatively in 12 patients scheduled for AVR and in 31 patients scheduled for TAVI. Echocardiographic examinations were performed pre-, intra- and postoperatively. Nine patients (75%) undergoing AVR and 18 patients (58%) undergoing TAVI showed pathological VWF functionality preoperatively (p = 0.48). Five to 7 days postoperatively, VWF functionality normalised in all patients with AVR, four of them with mild paravalvular regurgitation. VWF functionality was still altered in nine patients after TAVI (p = 0.044 between groups), five of them with and four without mild paravalvular regurgitation (p = 0.1).Altered VWF functionality was observed in nearly one-third of patients after TAVI, but not after AVR. This phenomenon was not related to paravalvular regurgitation, but may indicate differences in the response of the haemostatic system to the prosthetic heart valve design or the valve replacement procedure.

Changes in von Willebrand factor-cleaving protease (ADAMTS-13) in patients with aortic stenosis undergoing valve replacement or balloon valvuloplasty

2012 ◽  
Vol 108 (07) ◽  
pp. 86-93 ◽  
Author(s):  
Sammy Elmariah ◽  
Louis Aledort ◽  
Jeffrey Dlott ◽  
Paul Stelzer ◽  
Jonathan Halperin ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Stenosis ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Von Willebrand Factor ◽  
Multivariable Analysis ◽  
Acquired Von Willebrand Syndrome ◽  
Postoperative Changes ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryIt was the objective of this study to determine whether reduced cleavage of von Willebrand factor (VWF) multimers following aortic valve replacement (AVR) is a consequence of reduced shear stress or postoperative changes in VWF cleavage protease (ADAMTS-13) activity. Aortic stenosis (AS) may be complicated by acquired von Willebrand disease. Aortic valve replacement (AVR) corrects the associated haematologic abnormalities. We enrolled 114 patients with severe AS scheduled for either balloon aortic valvuloplasty (BAV; n=64) or AVR (n=50). Haematologic assessments of VWF levels and activity and ADAMTS-13 were performed before and 24 hours after valve intervention. The VWF:RCo to VWF:Ag ratio, a surrogate for large VWF multimer activity, increased by 37% (p < 0.0001) after AVR and by 10% (p = 0.0002) after BAV. ADAMTS-13 activity significantly decreased after AVR (579 ± 127 to 468 ± 135 ng/ml; p<0.0001), but not after BAV (484 ± 153 to 529 ± 185 ng/ml; p = 0.10). By multivariable analysis, the change in VWF:RCo ratio after AVR was more strongly associated with the fall in ADAMTS-13 than with reduction of valve gradient; whereas the change in gradient better predicted the rise in VWF:RCo after BAV. In conclusion, both BAV and AVR reverse the haematological abnormalities of the acquired von Willebrand syndrome of AS and ADAMTS-13 levels decrease after AVR. These findings suggest that a portion of the haematologic benefit of AVR may be due to a postoperative decline in ADAMTS-13 rather than solely to relief of AS as previously thought.

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