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Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients.

Publication ,  Journal Article
Crow, S; Milano, C; Joyce, L; Chen, D; Arepally, G; Bowles, D; Thomas, W; Ortiz, NV
Published in: ASAIO J
2010

A higher rate of nonsurgical bleeding has been observed in nonpulsatile left ventricular assist device (LVAD) recipients. von Willebrand factor (vWF) profiles were compared for nonpulsatile and pulsatile LVAD recipients to explore mechanisms that may contribute to the development of postimplant nonsurgical bleeding. The nonpulsatile mechanism may impair vWF function by creating a deficiency in vWF high molecular weight multimers (HMWMs), essential for hemostasis. High molecular weight multimer deficiency should result in low ristocetin cofactor (RCo) to vWF antigen ratios (vWF:RCo/vWF:Ag) because of impaired platelet (plt)-binding ability. von Willebrand factor profiles and HMWM were measured pre- and post-LVAD placement in 11 nonpulsatile (HeartMate II [HM II[) and 3 pulsatile (HeartMate XVE [HM XVE]) recipients. All the nonpulsatile LVAD recipients exhibited loss of HMWM 30 days postimplant. The vWF:RCo/vWF:Ag ratio was significantly lower after LVAD placement in the nonpulsatile group when compared with the pulsatile group. In addition, the vWF:RCo/vWF:Ag ratio decreased significantly from baseline 30 days postimplant within the nonpulsatile recipients. All nonpulsatile LVAD recipients had low vWF:RCo/vWF:Ag ratios 30 days post-LVAD even if the values were normal at baseline. These data suggest that nonpulsatile HM II recipients develop HMWM loss and impaired vWF platelet (plt)-binding ability after LVAD placement. Similar results were not observed in our small series of pulsatile HM XVE recipients. This finding could suggest a contributing factor to the increase in nonsurgical bleeding observed in nonpulsatile LVAD patients. Further investigation is ongoing to identify specific causes of vWF impairment.

Duke Scholars

Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2010

Volume

56

Issue

5

Start / End Page

441 / 445

Location

United States

Related Subject Headings

  • von Willebrand Factor
  • Pulsatile Flow
  • Postoperative Hemorrhage
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Female
  • Biomedical Engineering
  • 4003 Biomedical engineering
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Crow, S., Milano, C., Joyce, L., Chen, D., Arepally, G., Bowles, D., … Ortiz, N. V. (2010). Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients. ASAIO J, 56(5), 441–445. https://doi.org/10.1097/MAT.0b013e3181e5de0a
Crow, Sheri, Carmelo Milano, Lyle Joyce, Dong Chen, Gowthami Arepally, Dawn Bowles, William Thomas, and Nestor Villamizar Ortiz. “Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients.ASAIO J 56, no. 5 (2010): 441–45. https://doi.org/10.1097/MAT.0b013e3181e5de0a.
Crow S, Milano C, Joyce L, Chen D, Arepally G, Bowles D, et al. Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients. ASAIO J. 2010;56(5):441–5.
Crow, Sheri, et al. “Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients.ASAIO J, vol. 56, no. 5, 2010, pp. 441–45. Pubmed, doi:10.1097/MAT.0b013e3181e5de0a.
Crow S, Milano C, Joyce L, Chen D, Arepally G, Bowles D, Thomas W, Ortiz NV. Comparative analysis of von Willebrand factor profiles in pulsatile and continuous left ventricular assist device recipients. ASAIO J. 2010;56(5):441–445.

Published In

ASAIO J

DOI

EISSN

1538-943X

Publication Date

2010

Volume

56

Issue

5

Start / End Page

441 / 445

Location

United States

Related Subject Headings

  • von Willebrand Factor
  • Pulsatile Flow
  • Postoperative Hemorrhage
  • Middle Aged
  • Male
  • Humans
  • Heart-Assist Devices
  • Female
  • Biomedical Engineering
  • 4003 Biomedical engineering