Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.

AIM: Patients with severe aortic stenosis (AS) may have bleeding episodes due to the loss of high-molecular-weight (HMW) von Willebrand factor multimers (VWFMs). The absence of HMW-VWFMs and bleeding tendency are usually corrected after aortic valve replacement (AVR). To investigate the process of VWFM recovery and symptoms in patients with severe AS, we analyzed changes in VWF antigen (VWF:Ag), ADAMTS13 activity (ADAMTS13:AC), and platelet thrombus formation under high shear stress conditions. METHODS: Nine patients with severe AS undergoing AVR were analyzed. RESULTS: Evident deficiency of HMW-VWFMs was observed in six patients before surgery, which was rapidly restored within 8 days after AVR. Median levels of VWF:Ag before surgery, on postoperative days (PODs) 1, 8, 15, and 22, and one year after AVR were 78.1%, 130%, 224%, 155%, 134%, and 142%, respectively. In contrast, ADAMTS13:AC was 50.5%, 35.5%, 25.5%, 25.1%, 30.3%, and 84.6%, respectively. Preoperative thrombus formation but not surface coverage was significantly lower than that on POD 22, which was considered as normal level in each patient. Compared with preoperative levels, thrombus volume was significantly lower on POD 1, but rapidly increased by POD 8. CONCLUSION: Bleeding tendency and loss of HMW-VWFMs observed in patients with severe AS before surgery was rapidly corrected after AVR. Instead, patients were in a VWF-predominant state between POD 8 and 22.;博士(医学)・乙第1395号・平成29年3月15日;Copyright © 2016 Japan Atherosclerosis Society;本論文の著作権は日本動脈硬化学会が保持しています。;This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.;開始ページ : 1150;終了ページ : 1158;PubMed番号 : http://www.ncbi.nlm.nih.gov/pubmed/27052664

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書名 Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.
著作者等 日本動脈硬化学会
Abe Takehisa
Fujimura Yoshihiro
Hayakawa Masaki
Hayata Yoshihiro
Matsumoto Masanori
Sugimoto Mitsuhiko
Taniguchi Shigeki
Yagi Hideo
Yamaguchi Naoko
Yamashita Keigo
書名別名 重度大動脈弁狭窄症患者の大動脈弁置換術後における血小板機能および高分子量 von Willebrand 因子多量体の急速な回復
出版元 日本動脈硬化学会
刊行年月 1994-2009
ページ数 v.
大きさ 28 cm
ISSN 13403478
NCID AA11018976
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全国書誌番号
10048537
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言語 英語
出版国 日本
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