Restoration of von Willebrand factor after transcatheter aortic valve replacement—A possible cause for posttranscatheter aortic valve replacement thrombocytopenia?

Objectives The aim of the current study was to analyze the clinical and procedural predictors of thrombocytopenia and the relationship between the decrease in platelet count (DPC) and change in vWF function (ΔvWF) after transcatheter aortic valve replacement (TAVR). Background TAVR often causes temp...

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Published in:Catheterization and cardiovascular interventions 2023-12, Vol.102 (7), p.1376-1385
Main Authors: Roth, Nastasia, Heidel, Carolin, Xu, Congde, Hubauer, Ute, Wallner, Stefan, Meindl, Christine, Holzamer, Andreas, Hilker, Michael, Creutzenberg, Marcus, Sossalla, Samuel, Maier, Lars, Jungbauer, Carsten, Debl, Kurt
Format: Article
Language:English
Subjects:
Aortic stenosis
Aortic valve
Aortic Valve - diagnostic imaging
Aortic Valve - surgery
aortic valve replacement
Aortic Valve Stenosis - complications
Aortic Valve Stenosis - diagnostic imaging
Aortic Valve Stenosis - surgery
Humans
Multivariate analysis
platelet consumption
Platelets
Risk Factors
TAVR
Thrombocytopenia
Thrombocytopenia - diagnosis
Thrombocytopenia - etiology
Transcatheter Aortic Valve Replacement - adverse effects
Treatment Outcome
Von Willebrand factor
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Summary:Objectives The aim of the current study was to analyze the clinical and procedural predictors of thrombocytopenia and the relationship between the decrease in platelet count (DPC) and change in vWF function (ΔvWF) after transcatheter aortic valve replacement (TAVR). Background TAVR often causes temporary thrombocytopenia. At the same time, TAVR leads to a restoration of von Willebrand factor (vWF) function. Methods One hundred and forty‐one patients with severe aortic stenosis undergoing TAVR were included in the study. Platelet count and vWF function (vWF:Ac/Ag ratio) were assessed at baseline and 6 h after TAVR. Thrombocytopenia was defined as platelet count  20% had significantly higher ΔvWF (10.9% vs. 6.5%, p = 0.021). Obese patients showed a significantly lower DPC (11.8% vs. 19.9%, p = 0.001). In multivariate analysis, ΔvWF 6 h after TAVR was the only significant predictor for DPC > 20% (p = 0.017). Conclusions The restoration of vWF after TAVR is a significant predictor for DPC after TAVR. An increased platelet consumption due to vWF restoration could play a key role in the development of thrombocytopenia after TAVR.
ISSN:1522-1946
1522-726X
DOI:10.1002/ccd.30841