TY - JOUR
T1 - Immediate recovery of acquired von willebrand syndrome after left ventricular assist device explantation
T2 - Implications for heart transplantation
AU - Davis, Mary E.
AU - Haglund, Nicholas A.
AU - Tricarico, Nicole M.
AU - Matafonov, Anton
AU - Gailani, David
AU - Maltais, Simon
PY - 2015/1/13
Y1 - 2015/1/13
N2 - All patients supported with continuous flow-left ventricular assist devices (CF-LVADs) develop acquired von Willebrand syndrome due to the loss of von Willebrand factor (vWF) high molecular weight (HMW) multimers and this phenomenon has been associated with clinical manifestation of bleeding diatheses. The precise timing of postoperative recovery of HMW multimers and correction of this condition after CF-LVAD explantation and heart transplantation is unknown. We sought to determine the specific timing of HMW multimer recovery by serially quantifying plasma vWF multimer ratios after CF-LVAD explant and orthotopic heart transplantation (OHT) in a patient implanted with a HeartWare ventricular assist device. Using densitometric analysis of multimer patterns, we demonstrated complete recovery of HMW multimers within the first few hours following CF-LVAD explant and OHT. These findings have critical implications in the context of perioperative bleeding diatheses in patients bridged to transplantation with a CF-LVAD.
AB - All patients supported with continuous flow-left ventricular assist devices (CF-LVADs) develop acquired von Willebrand syndrome due to the loss of von Willebrand factor (vWF) high molecular weight (HMW) multimers and this phenomenon has been associated with clinical manifestation of bleeding diatheses. The precise timing of postoperative recovery of HMW multimers and correction of this condition after CF-LVAD explantation and heart transplantation is unknown. We sought to determine the specific timing of HMW multimer recovery by serially quantifying plasma vWF multimer ratios after CF-LVAD explant and orthotopic heart transplantation (OHT) in a patient implanted with a HeartWare ventricular assist device. Using densitometric analysis of multimer patterns, we demonstrated complete recovery of HMW multimers within the first few hours following CF-LVAD explant and OHT. These findings have critical implications in the context of perioperative bleeding diatheses in patients bridged to transplantation with a CF-LVAD.
KW - acquired von Willebrand syndrome
KW - cardiac transplantation
KW - left ventricular assist device
KW - perioperative bleeding
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U2 - 10.1097/MAT.0000000000000157
DO - 10.1097/MAT.0000000000000157
M3 - Article
C2 - 25251586
AN - SCOPUS:84930179535
VL - 61
SP - e1-e4
JO - ASAIO Journal
JF - ASAIO Journal
SN - 1058-2916
IS - 1
ER -