Von Willebrand factor in aortic or mitral valve stenosis and bleeding after heart valve surgery

2021 ◽  
Vol 198 ◽  
pp. 190-195
Author(s):  
Piotr Mazur ◽  
Joanna Natorska ◽  
Michał Ząbczyk ◽  
Łukasz Krzych ◽  
Radosław Litwinowicz ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Heart Valve ◽  
Von Willebrand Factor ◽  
Valve Surgery ◽  
Mitral Valve Stenosis ◽  
Heart Valve Surgery ◽  
Von Willebrand ◽  
Willebrand Factor

scholarly journals Use of Suture tightening automated device COR-KNOT® for minimally invasive heart valve surgery: Our initial experience in Bangladesh

2019 ◽  
Vol 34 (2) ◽  
pp. 127-131
Author(s):  
Md Faizus Sazzad ◽  
Nusrat Ghafoor ◽  
Siba Pada Roy ◽  
Swati Munshi ◽  
Feroza Khanam ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Valve ◽  
Mitral Valve Repair ◽  
Case Series ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Valve Repair

Background: COR-KNOT® (LSI Solutions, New York, NY, USA) is an automated suture securing device has not been well known. We report a case series for first automated knotting device used for minimally invasive heart valve surgery in Bangladesh. Method and Results: To overcome the challenge of knot securing via a Key-Hole surgery we have used CORKNOT ®. The newest device is capable of remotely and automatically secure sutures and simultaneously can cut and remove the excess suture tails. We covered the spectrum of heart valve surgery: There was one case of bioprosthetic aortic valve replacement, one case of mitral valve repair, one case of bioprosthetic mitral valve replacement, one case of failed mitral valve repair with COR-KNOT® explantation followed by mechanical mitral valve replacement and one case of redo-mitral valve replacement. Average length of hospital stays was 5 ± 1days. There was one reopening, one post-operative atrial fibrillation. No wound infection and no 30day mortality. Conclusion: We conclude, COR-KNOT® is a safe and effective tool to reduce the duration of operation. Clinical outcome of heart valve surgery with COR-KNOT® is comparable with other methods of suture tying methods. Bangladesh Heart Journal 2019; 34(2) : 127-131

scholarly journals von Willebrand Factor and Management of Heart Valve Disease

2019 ◽  
Vol 73 (9) ◽  
pp. 1078-1088 ◽  
Author(s):  
Eric Van Belle ◽  
Flavien Vincent ◽  
Antoine Rauch ◽  
Caterina Casari ◽  
Emmanuelle Jeanpierre ◽  
...  
Keyword(s):  
Heart Valve ◽  
Von Willebrand Factor ◽  
Valve Disease ◽  
Heart Valve Disease ◽  
Von Willebrand ◽  
Willebrand Factor

THIRTY YEARS EXPERIENCE WITH HEART VALVE SURGERY: ISOLATED MITRAL VALVE REPLACEMENT

1996 ◽  
Vol 66 (12) ◽  
pp. 806-812 ◽  
Author(s):  
Justin R. Bessell ◽  
Georgina Gower ◽  
David R. Craddock ◽  
John Stubberfield ◽  
Guy J. Maddern
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Valve ◽  
Valve Surgery ◽  
Heart Valve Surgery

P4799Long-term thromboembolic risk in patients with postoperative atrial fibrillation after left-sided heart valve surgery

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J H Butt ◽  
J B Olesen ◽  
A Gundlund ◽  
P S Olsen ◽  
E Havers-Borgersen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Heart Valve ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Oral Anticoagulation Therapy ◽  
New Onset

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery. However, data on the long-term risk of thromboembolism in patients who develop POAF after heart valve surgery are sparse. In addition, data on stroke prophylaxis in this setting are lacking. Objective To assess the long-term risk of thromboembolism in patients developing new-onset POAF following isolated left-sided heart valve surgery relative to patients with nonsurgical, nonvalvular atrial fibrillation (NVAF). Methods Using data from the Eastern Danish Heart Surgery Database and Danish nationwide registries, we identified patients who developed POAF following isolated left-sided heart valve surgery (i.e. biologic aortic/mitral valve replacement or aortic/mitral valve repair) from 2000 through 2015. These patients were matched with patients with nonsurgical NVAF in a 1:4 ratio by age, sex, heart failure, hypertension, diabetes, a history of thromboembolism, ischemic heart disease, and year of diagnosis. Long-term risk of thromboembolism was examined by the Aalen-Johansen estimator and cause-specific Cox regression models adjusted for comorbidities, concomitant pharmacotherapy, and oral anticoagulation therapy as a time-dependent covariate. Results A total of 1,539 patients undergoing isolated left-sided heart valve surgery were identified. Of these, 716 (46.5%) patients developed POAF after surgery. A total of 630 patients with POAF were matched with 2,520 patients with NVAF. In the matched study population, the median age was 71 years (25th-75th percentile 66–77 years) and 59.5% were men. Oral anticoagulation therapy was initiated within 30 days post-discharge in 62.7% and 51.4% of these patients, respectively. Compared with NVAF, POAF was not associated with a significantly different 5-year absolute risk of thromboembolism (10.7% [95% confidence interval [CI], 8.0%-13.9%] versus 8.9% [95% CI, 7.6%-10.2%] in the POAF and NVAF group, respectively) (Figure). In the adjusted analysis, the long-term risk of thromboembolism was similar in patients with POAF and NVAF (hazard ratio [HR] 1.01 [95% CI, 0.71–1.44]). Anticoagulation therapy during follow-up was associated with a lower risk of thromboembolic events in patients with POAF (HR 0.45 [95% CI, 0.18–0.99]) as well as NVAF (HR 0.58 [95% CI, 0.42–0.80]) compared with no anticoagulation therapy. Conclusions New-onset POAF following isolated left-sided heart valve surgery was associated with a similar long-term risk of thromboembolism compared with NVAF. Future studies addressing the role of oral anticoagulation therapy in POAF after heart valve surgery are warranted to examine the efficacy and safety as well as the timing and duration of anticoagulation therapy.

scholarly journals Performance of The Society of Thoracic Surgeons 2008 Cardiac Risk Models for Major Postoperative Complications after Heart Valve Surgery in a Chinese Population: A Multicenter Study

2018 ◽  
Vol 21 (4) ◽  
pp. E281-E285
Author(s):  
Chong Wang ◽  
Lei Jin ◽  
Fan Qiao ◽  
Qing Xue ◽  
Xin Guan Zhang ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Mitral Valve ◽  
Incidence Rate ◽  
Valve Replacement ◽  
Heart Valve ◽  
Roc Curve ◽  
Valve Surgery ◽  
Chinese Patients ◽  
Risk Scores ◽  
Heart Valve Surgery

Background: To evaluate the performance of Society of Thoracic Surgeons (STS) 2008 cardiac surgery risk scores for postoperative complications in Chinese patients undergoing single valve surgery at multicenter institutions.  Methods: From January 2009 through December 2012, 4493 consecutive patients older than 16 years who underwent single valve surgery at 4 cardiac surgical centers were collected and scored according to the STS 2008 risk scores. The final research population included the following isolated heart valve surgery types: aortic valve replacement, mitral valve replacement, and mitral valve repair. Calibration of the risk scores was assessed by the Hosmer–Lemeshow (H-L) test. Discrimination was tested by calculating the area under the receiver operating characteristic (ROC) curve.  Results: The observed incidence rate for cerebrovascular accident (CVA), renal failure (RF), prolonged ventilation (Vent), reoperation (Reop), prolonged postoperative length of stay (PLOS), and short postoperative LOS (SLOS) was 0.90%, 1.32%, 4.18%, 2.43%, 3.64%, and 1.65%, respectively. The predicted incidence rate for CVA, RF, Vent, Reop, PLOS, and SLOS was 0.76%, 1.55%, 4.94%, 6.69%, 3.92%, and 2.54%, respectively. The STS 2008 risk scores give an accurate calibration for individual postoperative risk in CVA, RF, Vent, and PLOS (Hosmer–Lemeshow: P = .052, P = .474, P = .468, and P = .712, respectively). The area under the ROC curve of the STS 2008 risk scores for the above 4 postoperative complications were 0.714, 0.724, 0.727%, and 0.713, respectively. Conclusion: The STS 2008 risk scores were suitable for major postoperative complications in patients undergoing single valve surgery, except for Reop and SLOS. 

Severe Aortic and Mitral Valve Regurgitation Are Associated with von Willebrand Factor Defect.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 1790-1790 ◽  
Author(s):  
Sophie Susen ◽  
Andre Vincentelli ◽  
Thierry Le Tourneau ◽  
Claudine Caron ◽  
Christophe Zawadzki ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Von Willebrand Factor ◽  
Severe Aortic Stenosis ◽  
Mitral Valve Regurgitation ◽  
Binding Activity ◽  
Valve Regurgitation ◽  
Closure Time ◽  
Mucosal Bleeding ◽  
Von Willebrand ◽  
Willebrand Factor

Abstract Severe aortic stenosis can be associated with mucosal and gastrointestinal bleeding probably related to loss of high molecular weight (HMW) multimers of VWF. Possible mechanisms of this loss are enhanced proteolysis by shear-dependant metalloprotease (ADAMTS 13) of HMW multimers of VWF or increased platelet-VWF interactions leading to clearance or degradation of HMW multimers of VWF. The aim of our study was to investigate wether this high shear-stress induced loss of HMW multimers of VWF is observed in other cardiac defects associated with high pressure blood flow such as severe aortic or mitral valve regurgitation. Twenty four consecutive patients were operated on for aortic valve regurgitation (n=11) or mitral valve regurgitation (n=13). Before surgery recent mucosal bleeding was reported in 25% patients (n=5).VWF Closure Time of PFA 100® (CTADP) were prolonged in 87% of patients (n=20). The ratio of ristocetin cofactor activity to antigen and the ratio of collagen-binding activity to antigen were decreased in 28%(n=5) and 45%(n=10) of patients respectively. HMW multimers of VWF were decreased in 82 % (n=18) of patients. Six months after surgery, CTADP were normal in 71% (n=17) of patients, ratios were normal in all patients evaluable for this parameter (n=14) and HMW multimers of VWF increased in all patients as compared with preoperative value (8±2,5%vs10±2,3; p=0.04) but remain under value of control plasma in 63% (n=14) of patients. In this study we demonstrated that VWF defect can be associated with severe aortic or mitral valve regurgitation and that platelet function-analyzer closure time, abnormalities of von Willebrand factor, or both could be frequent in those valve disease and might cause mucosal bleeding.

Von Willebrand Factor and Mitral Valve Prolapse

1988 ◽  
Vol 60 (02) ◽  
pp. 230-231 ◽  
Author(s):  
P Froom ◽  
T Margulis ◽  
E Grenadier ◽  
A Palant ◽  
M David ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Mitral Valve ◽  
Von Willebrand Factor ◽  
Mitral Valve Prolapse ◽  
Chordae Tendineae ◽  
The Mean ◽  
Low Levels ◽  
Von Willebrand ◽  
Willebrand Factor

SummaryThe levels of von Willebrand factor (vWF: Ag) were measured in 27 patients with mitral valve prolapse (MVP) and compared to 27 age matched controls. Decreased levels of vWF:Ag (<80%) were found in 59% (16/27) of those with MVP compared to only 7% (2/27) of the controls (p <0.001). Mean vWF: Ag levels were also significantly lower in those with MVP (68 ± 30% versus 100 ± 23%, p <0.001). In those with MVP and congestive heart failure secondary to ruptured chordae tendineae, however, the mean level of vWF:Ag was not significantly different from control values (95 ± 32). There was an increased incidence of recurrent nose bleeds in those with MVP and low levels of vWF: Ag. We conclude that there is a relationship between MVP and low levels of vWF:Ag which may explain the increased incidence of epistaxis in such patients. Increased release of vWF: Ag in those with MVP and concomitant congestive heart failure may account for the normal levels found in this subgroup.

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