Von willebrand factor proteolysis by adamts-13 in patients on left ventricular assist device support

Left ventricle assist devices (LVADs) have significantly improved the survival of patients with end-stage heart failure, but device-related hemostatic complications remain common and are associated with poor outcomes. The bleeding diathesis, primarily found in gastrointestinal (GI) tract at the site of an arteriovenous malformation,1,2 is believed to be caused by the loss of large von Willebrand factor (VWF) in plasma, leading to the term of acquired von Willebrand syndrome (AVWS). LVAD-associated AVWS is believed to be caused by the excessive cleavage of large VWF multimers by the metalloprotease ADAMTS-13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) in a high shear stress environment of the LVAD-driven blood flow.

Source: The Journal of Heart and Lung Transplantation - January 13, 2017 Category: Transplant Surgery Authors: Angelo Nascimbene, Tristan Hilton, Barbara A. Konkle, Joel L. Moake, O.H. Frazier, Jing-fei Dong Source Type: research