Acquired and Reversible von Willebrand Disease With High Shear Stress Aortic Valve Stenosis

Yoshida, Kazunori; Tobe, Satoshi; Kawata, Masahito; Yamaguchi, Masahiro

doi:10.1016/j.athoracsur.2005.07.074

Cited by 88 publications

(64 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…AvWD develops in patients with aortic stenosis when high shear stress increases proteolysis BTT bridge to transplant, DT destination therapy, CVA cerebrovascular accident a Total of five CVA, one event not listed as ischemic or hemorrhagic of the HMW multimers of vWF [32,33]. As vWF is subjected to high shear stress as it passes through the stenotic valve, the HMW multimers are cleaved, and the reduced concentration decreases platelet function and increases the patient's susceptibility to bleed.…”

Section: Acquired Von Willebrand's Diseasementioning

confidence: 97%

Hematologic Effects of Continuous Flow Left Ventricular Assist Devices

Slaughter

2010

J. of Cardiovasc. Trans. Res.

104

View full text Add to dashboard Cite

The extent of hematologic effects of the new continuous flow left ventricular assist devices (CF-LVAD) has not been studied. Recent clinical studies have demonstrated that hemolysis and thrombosis are not common during CF-LVAD support, however, the incidence of bleeding remains a concern. The rate of postoperative bleeding is similar to that of the prior generation pulsatile LVAD, but gastrointestinal bleeding due to angiodysplasia and arteriovenous malformations is more common and appears to be related to the blood flow rheology of these devices. New evidence suggests that acquired von Willebrand's disease develops in some patients due to the reduction in high molecular weight (HMW) multimers of von Willebrand's factor (vWF). Similar to acquired von Willebrand's disease seen in patients with aortic stenosis, the shear stress of the CF-LVAD may cause proteolysis of the HMW multimers of vWF. In addition to acquired von Willebrand's disease, there is activation of the fibrinolytic system and a loss of platelet numbers and function during CF-LVAD support. The hematologic responses during CF-LVAD support are constantly changing, and antiplatelet therapy may need to be adjusted accordingly. Considerable research is needed to better define the complex hematologic effects during CF-LVAD support. Screening of patients for angiodysplasia and von Willebrand's disease before CF-LVAD implant may allow for effective preemptive treatment. Because bleeding causes significant morbidity for this population, more effective treatment strategies need to be developed.

show abstract

Section: Acquired Von Willebrand's Diseasementioning

confidence: 97%

Hematologic Effects of Continuous Flow Left Ventricular Assist Devices

Slaughter

2010

J. of Cardiovasc. Trans. Res.

104

View full text Add to dashboard Cite

show abstract

“…32 Sequestration of high-molecular-weight (HMW) multimers was demonstrated in patients with hematologic disorders because of adsorption to myeloma cells or platelets, but also in reactive thrombocytosis. [33][34][35][36] Proteolytic cleavage of VWF can occur after shear stress-induced unfolding, 37,38 and AVWS resulting from this mechanism was described in disorders with increased shear stress, in particular aortic valve stenosis 19,37,39 and LVAD. [20][21][22] Proteolytic cleavage has also been described in patients with pancreatitis, liver cirrhosis, leukemia, and certain medications.…”

Section: Pathogenesismentioning

confidence: 99%

How I treat the acquired von Willebrand syndrome

Tiede

Rand

Budde³

et al. 2011

Blood

294

330

View full text Add to dashboard Cite

“…The second most common groups of disorders associated with aVWS is neoplasia, including Wilms tumors [52][53][54][55][56][57] and carcinomas [58,59], followed by immunological diseases, most notably SLE [14,60,61] and hypothyroidism [62][63][64][65][66][67][68][69][70][71][72][73][74][75]. Various other clinical conditions (Table I), such as rare immunological disorders [76][77][78][79], cardiovascular diseases [80][81][82][83][84][85][86][87], treatments using antibiotics [88][89][90], anticonvulsants [91], plasma volume expander [92][93][94] or recombinant factor VIII infusion [95], uremia [96][97]…”

Section: Associated Disorders and Pathogenic Mechanismsmentioning

confidence: 99%

Acquired von Willebrand syndrome: An update

Franchini

Lippi

2006

American J Hematol

View full text Add to dashboard Cite

Acquired von Willebrand syndrome (aVWS) is a rare bleeding disorder with laboratory findings similar to those for congenital von Willebrand disease (VWD). However, unlike congenital VWD, it arises in individuals with no personal or family history of bleeding. aVWS occurs in association with a variety of underlying disorders, most frequently in lymphoproliferative disorders, myeloproliferative disorders, and cardiovascular diseases. Through an analysis of the more recent literature data, the pathophysiology and the clinical, laboratory, and therapeutic aspects of this syndrome are concisely reported in this review. Am. J. Hematol. 82:368-375, 2007. V V C 2006 Wiley-Liss, Inc.

show abstract

Acquired and Reversible von Willebrand Disease With High Shear Stress Aortic Valve Stenosis

Cited by 88 publications

References 26 publications

Hematologic Effects of Continuous Flow Left Ventricular Assist Devices

Hematologic Effects of Continuous Flow Left Ventricular Assist Devices

How I treat the acquired von Willebrand syndrome

Acquired von Willebrand syndrome: An update

Contact Info

Product

Resources

About