Von Willebrand factor, a versatile player in gastrointestinal bleeding in left ventricular assist device recipients?

Details

Serval ID
serval:BIB_6B3A51EE9230
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Von Willebrand factor, a versatile player in gastrointestinal bleeding in left ventricular assist device recipients?
Journal
Transfusion
Author(s)
Fischer Q., Huisse M.G., Voiriot G., Caron C., Lepage L., Dilly M.P., Nataf P., Ajzenberg N., Kirsch M.
ISSN
1537-2995 (Electronic)
ISSN-L
0041-1132
Publication state
Published
Issued date
01/2015
Peer-reviewed
Oui
Volume
55
Number
1
Pages
51-54
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Abstract
Bleeding originating in the gastrointestinal (GI) tract is one of the most common adverse events after left ventricular assist device (LVAD) implantation. In these patients, GI bleeding appears to be the consequence of altered hemostasis on the one hand and alterations of the GI microvasculature on the other.
We report the case of a patient who suffered repeated, severe GI bleeding early after implantation of a HeartMate II continuous-flow LVAD.
After failure of conventional treatment strategies, GI bleeding was controlled using repeated transfusions of a purified von Willebrand factor (VWF) concentrate, almost devoid of Factor VIII (Wilfactin, LFB). No episodes of pump thrombosis were noted. Subsequent to VWF transfusions, we observed a progressive normalization of circulating vascular endothelial growth factor levels.
Our data raise the possibility that, in addition to its hemostatic properties, transfusions of VWF might have acted as an antiangiogenic factor.
Keywords
Aged, Combined Modality Therapy, Deamino Arginine Vasopressin/therapeutic use, Embolization, Therapeutic, Erythrocyte Transfusion, Fibrinogen/therapeutic use, Gastrointestinal Hemorrhage/etiology, Gastrointestinal Hemorrhage/therapy, Heart Ventricles, Heart-Assist Devices/adverse effects, Hemostatics/therapeutic use, Humans, Laser Coagulation, Male, Neovascularization, Physiologic/drug effects, Postoperative Hemorrhage/etiology, Postoperative Hemorrhage/therapy, Recurrence, Tranexamic Acid/therapeutic use, von Willebrand Factor/physiology, von Willebrand Factor/therapeutic use
Pubmed
Web of science
Create date
28/03/2019 17:36
Last modification date
20/08/2019 14:25
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