Document Detail


No evidence for increased intraoperative bleeding in aortic-valve stenosis: a comparative analysis of haemotherapy in 136 patients undergoing aortic-valve replacement.
MedLine Citation:
PMID:  21302674     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: An association of aortic-valve stenosis and abnormal bleeding, particularly from gastrointestinal angiodysplasia, has been reported. In this setting, high-shear stress generated by the transvalvular gradient leads to a conformational change of plasmic von Willebrand factor, making this adhesive protein more susceptible for proteolytic cleavage. Consequently, highest-molecular weight multimers of the von Willebrand factor are degraded through a von Willebrand factor specific protease leading to impaired platelet-related haemostasis.
METHODS AND RESULTS: To assess the role of aortic-valve stenosis as a factor predicting abnormal intraoperative bleeding in patients suffering from aortic-valve stenosis, we compared the number of intraoperatively administered blood components during aortic-valve replacement for aortic-valve stenosis (n = 50), aortic-valve insufficiency (n = 19) and combined aortic-valve defects (n = 67). As a result, the three subgroups did not differ significantly regarding the mean number of transfused red-blood cell units (0.94 +/- 1.36, 0.4 +/- 0.9, or 0.86 +/- 1.3, respectively) and plasma units (0.04 +/- 0.28, 0.21 +/- 0.71, or 0.15 +/- 0.61, respectively). None of the patients received platelet concentrates. A multivariate logistic regression model adjusted for age and gender did not show an influence of the presence and severity of aortic-valve stenosis on intraoperatively applied haemotherapy.
CONCLUSION: Along with our findings, the presence or severity of aortic-valve stenosis does not predict an increased need for intraoperative transfusion of blood components. Thus, this cardiac defect does not seem to represent a major risk determinant for intraoperative bleeding despite the high prevalence of shear-stress induced von Willebrand factor abnormalities in this setting.
Authors:
Christoph Sucker; Peter Feindt; Rainer B Zotz; Jens Litmathe
Related Documents :
453044 - Submitral calcification or sclerosis in elderly patients: m mode and two dimensional ec...
10935334 - Mitral valve plasty in systemic lupus erythematosus in the setting of antiphospholipid ...
9517554 - Echocardiographic quantitation of mitral regurgitation: a new doppler technique.
15746734 - Imbalanced chordal force distribution causes acute ischemic mitral regurgitation: mecha...
9153124 - Transcranial doppler detected cerebral microembolism following carotid endarterectomy. ...
22713154 - Aortic stiffness as a tissue biomarker for predicting future cardiovascular events in a...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta cardiologica     Volume:  65     ISSN:  0001-5385     ISO Abbreviation:  Acta Cardiol     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2011-02-09     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370570     Medline TA:  Acta Cardiol     Country:  Belgium    
Other Details:
Languages:  eng     Pagination:  675-9     Citation Subset:  IM    
Affiliation:
LaboMed Coagulation Centre, Berlin, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Pulmonary veins branching pattern, assessed by magnetic resonance, does not affect transcatheter atr...
Next Document:  Paraoxonase 1 polymorphisms as the risk factor of coronary heart disease in a Thai population.