1. Acquired von Willebrand syndrome and factor VIII in patients with moderate to severe mitral regurgitation undergoing transcatheter mitral valve repair
- Author
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Theresia Koller, Florian Zeman, Michael Paulus, Bernhard Unsöld, Kurt Debl, Christoph Birner, Michael Hamerle, Stefan Buchner, Dominik Rogalski, Christine Meindl, Lars S. Maier, and Christian Schach
- Subjects
Gastrointestinal bleeding ,medicine.medical_specialty ,Cardiac Catheterization ,medicine.medical_treatment ,610 Medizin ,Clinical Investigations ,MitraClip, mitral valve repair, PASCAL, von Willebrand factor ,Regurgitation (circulation) ,030204 cardiovascular system & hematology ,von Willebrand factor ,03 medical and health sciences ,mitral valve repair ,0302 clinical medicine ,Von Willebrand factor ,Mitral valve ,Internal medicine ,Medicine ,Humans ,MitraClip ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Heart Valve Prosthesis Implantation ,PASCAL ,ddc:610 ,Mitral valve repair ,Mitral regurgitation ,Factor VIII ,biology ,business.industry ,Mitral Valve Insufficiency ,General Medicine ,medicine.disease ,von Willebrand Diseases ,medicine.anatomical_structure ,biology.protein ,Etiology ,Cardiology ,Mitral Valve ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background and Hypothesis: The acquired von Willebrand syndrome (AvWS), which predisposes to bleeding events, is often related to valvular heart diseases. We investigated possible implications of AvWS and factor VIII levels in patients with moderate to severe mitral regurgitation (MR) undergoing transcatheter mitral valve repair (TMVR). Methods and Results: 123 patients with moderate to severe MR were prospectively enrolled. Complete measurements of von Willebrand Factor activity (vWFAct), von Willebrand Factor antigen (vWFAg), and factor VIII expression before and 4 weeks after TMVR were available in 85 patients. At baseline, seven patients had a history of gastrointestinal bleeding, two patients suffered bleeding events during their hospital stay, and one patient had a bleeding 4 weeks after TMVR. Even though vWFAct, vWFAct/vWFAg ratio and vWFAg values did not change after TMVR, we observed a significantly lower vWFAct/vWFAg ratio in patients with primary MR as compared to patients with secondary MR both at baseline (p = 0.022) and 4 weeks following the TMVR procedure (p = 0.003). Additionally, patients with a mean mitral valve gradient ≥4 mmHg after TMVR had significantly lower vWFAct/vWFAg ratios as compared to patients with a mean mitral valve gradient
- Published
- 2020