TY - JOUR
T1 - Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support
T2 - An In Vivo Study
AU - Saeed, Omar
AU - Rangasamy, Sabarivinoth
AU - Reyes Gil, Morayma
AU - Goldstein, Daniel J.
AU - Billett, Henny H.
AU - Jorde, Ulrich P.
AU - Patel, Snehal R.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.
AB - Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.
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U2 - 10.1097/MAT.0000000000000831
DO - 10.1097/MAT.0000000000000831
M3 - Article
C2 - 29863626
AN - SCOPUS:85060531220
VL - 64
SP - e123-e125
JO - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JF - ASAIO journal (American Society for Artificial Internal Organs : 1992)
SN - 1058-2916
IS - 5
ER -