Acquired von Willebrand syndrome and factor <scp>VIII</scp> in patients with moderate to severe mitral regurgitation undergoing transcatheter mitral valve repair

Meindl, Christine; Paulus, Michael; Koller, Theresia; Rogalski, Dominik; Hamerle, Michael; Schach, Christian; Büchner, Stefan; Zeman, Florian; Maier, Lars S.; Debl, Kurt; Unsöld, Bernhard; Birner, Christoph

doi:10.1002/clc.23538

Cited by 5 publications

(8 citation statements)

References 29 publications

(37 reference statements)

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“…There are reports of moderate or severe native mitral regurgitation to be associated with abnormal VWF multimers and clinically significant GI bleeding, which reversed after mitral valve surgery [ 15 ]. In 123 patients with moderate or severe native mitral regurgitation undergoing transcatheter mitral valve repair, Meindl et al reported that an elevated mean mitral valve gradient following transcatheter mitral valve repair was associated with a low post-procedure VWF activity [ 16 ]. However, this alteration did not translate into a higher incidence of bleeding events.…”

Section: Discussionmentioning

confidence: 99%

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding

Hussain¹,

Kattoor²,

Liu³

et al. 2023

Cureus

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IntroductionWe sought to investigate the association between left-sided prosthetic valve dysfunction and gastrointestinal (GI) bleeding. MethodsIn a retrospective cohort of patients with left-sided prostheses, we identified those who experienced one or more GI bleeds. The latest or chronologically closest echocardiogram to the GI bleed was analyzed by a blinded investigator for prosthetic valve dysfunction. ResultsAmong 334 unique patients, 166 had aortic prostheses, 127 had mitral prostheses, and 41 had both. A total of 58 (17.4%) subjects had GI bleeding events. Patients in the "GI Bleed" group had higher mean ejection fraction (56±14% vs. 49±15%; P = 0.003) and higher prevalence of hypertension, end-stage renal disease, and liver cirrhosis compared to the "No GI Bleed" group. There was a higher prevalence of moderate or severe prosthetic valve regurgitation in the GI Bleed vs. No GI Bleed group (8.6% vs. 2.2%; P = 0.027). Moderate or severe prosthetic valve regurgitation was independently associated with GI bleeding (odds ratio, 6.18; 95% confidence interval, 1.27-30.05; P = 0.024), after adjusting for ejection fraction, hypertension, end-stage renal disease and liver cirrhosis. Paravalvular regurgitation was associated with a higher incidence of GI bleeding compared to transvalvular regurgitation (35.7% vs. 11.9%; P = 0.044). The prevalence of prosthetic valve stenosis was similar between the GI Bleed and No GI Bleed groups (6.9% vs. 5.8%; P = 0.761). ConclusionIn a cohort of patients with predominantly surgically placed prosthetic valves, moderate to severe left-sided prosthetic valve regurgitation was independently associated with GI bleeding.

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Section: Discussionmentioning

confidence: 99%

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding

Hussain¹,

Kattoor²,

Liu³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…There are reports of moderate or severe native mitral regurgitation to be associated with abnormal VWF multimers and clinically signi cant GI bleeding, which reversed after mitral valve surgery (12). In 123 patients with moderate or severe native mitral regurgitation undergoing transcatheter mitral valve repair, Meindl et al reported that an elevated mean mitral valve gradient following transcatheter mitral valve repair was associated with a low post-procedure VWF activity (13). However, this alteration did not translate into a higher incidence of bleeding events.…”

Section: Discussionmentioning

confidence: 99%

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding Short Title: Prosthetic Valve Dysfunction and GI Bleeding

Hussain

Kattoor

Liu

et al. 2022

Preprint

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The association between left-sided prosthetic valve (PV) dysfunction and gastrointestinal (GI) bleeding is not well established. In a retrospective cohort of patients with left-sided prostheses, we identified those who experienced one or more GI bleeds. The latest or chronologically closest echocardiogram to the GI bleed was analyzed by a blinded investigator for PV dysfunction. Among 334 unique patients, 166 had aortic prostheses, 127 had mitral prostheses, and 41 had both. A total of 58 (17.4%) subjects had GI bleeding events. Patients in the “GI Bleed” group had higher mean ejection fraction (56 ± 14% vs. 49 ± 15%; P = 0.003) and higher prevalence of hypertension, end-stage renal disease, and liver cirrhosis compared to the “No GI Bleed” group. There was a higher prevalence of moderate or severe PV regurgitation in the GI Bleed vs. No GI Bleed group (8.6% vs. 2.2%; P = 0.027). Moderate or severe prosthetic valve regurgitation was independently associated with GI bleeding (odds ratio, 6.18; 95% confidence interval, 1.27–30.05; P = 0.024), after adjusting for ejection fraction, hypertension, end-stage renal disease and liver cirrhosis. Paravalvular regurgitation was associated with a higher incidence of GI bleeding compared to transvalvular regurgitation (35.7% vs. 11.9%; P = 0.044). The prevalence of PV stenosis was similar between the GI Bleed and No GI Bleed groups (6.9% vs. 5.8%; P = 0.761). In conclusion, among patients with predominantly surgically placed PV, moderate to severe left-sided PV regurgitation was independently associated with GI bleeding. PV stenosis was not associated with GI bleeding.

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“…The bleeding is typically attributed to gastrointestinal angiodysplasia, fragile and abnormal vessels immediately beneath the mucosa [ 8 ]. In addition to , hypertrophic obstructive cardiomyopathy [ 9 ], pulmonary hypertension [ 10 ], congenital structural heart diseases [ 11 ], mitral regurgitation (MR) [ [12] , [13] , [14] , [15] , [16] ], and mechanical circulatory support [ 17 , 18 ] have also been previously reported to cause AVWS.…”

Section: Introductionmentioning

confidence: 99%

“…MR has been reported as a cause of AVWS in several studies [ [12] , [13] , [14] , [15] , [16] ]. Blackshear et al.…”

Section: Introductionmentioning

confidence: 99%

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Mitral regurgitation is associated with similar loss of von Willebrand factor large multimers but lower frequency of anemia compared with aortic stenosis

Takiguchi,

Miura,

Shirai

et al. 2024

Research and Practice in Thrombosis and Haemostasis

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Acquired von Willebrand syndrome and factor VIII in patients with moderate to severe mitral regurgitation undergoing transcatheter mitral valve repair

Cited by 5 publications

References 29 publications

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding

Left-Sided Prosthetic Valve Dysfunction and Gastrointestinal Bleeding Short Title: Prosthetic Valve Dysfunction and GI Bleeding

Mitral regurgitation is associated with similar loss of von Willebrand factor large multimers but lower frequency of anemia compared with aortic stenosis

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