Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

Omar Saeed; Sabarivinoth Rangasamy; Morayma Reyes Gil; Daniel J. Goldstein; Henny H. Billett; Ulrich P. Jorde; Snehal R. Patel

doi:10.1097/MAT.0000000000000831

Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

Omar Saeed, Sabarivinoth Rangasamy, Morayma Reyes Gil, Daniel J. Goldstein, Henny H. Billett, Ulrich P. Jorde, Snehal R. Patel

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

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.

Original language	English (US)
Pages (from-to)	E123-E125
Journal	ASAIO Journal
Volume	64
Issue number	5
DOIs	https://doi.org/10.1097/MAT.0000000000000831
State	Published - Sep 1 2018

Keywords

Bleeding
Rotor speed
VWF deficiency

ASJC Scopus subject areas

Biophysics
Bioengineering
Biomaterials
Biomedical Engineering

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10.1097/MAT.0000000000000831

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Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support : An In Vivo Study. / Saeed, Omar; Rangasamy, Sabarivinoth; Gil, Morayma Reyes; Goldstein, Daniel J.; Billett, Henny H.; Jorde, Ulrich P.; Patel, Snehal R.

In: ASAIO Journal, Vol. 64, No. 5, 01.09.2018, p. E123-E125.

Research output: Contribution to journal › Article › peer-review

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title = "Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study",

abstract = "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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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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Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

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