Key result
Patient-prosthesis mismatch post-AVR creates high shear forces likely leading to acquired vWF deficiency.
Why the study?
Similar to aortic valve stenosis, patient-prosthesis mismatch after aortic valve replacement creates high shear forces that may induce acquired von Willebrand factor deficiency.
Does patient-prosthesis mismatch after aortic valve replacement lead to acquired von Willebrand factor deficiency?
Does patient-prosthesis mismatch after aortic valve replacement lead to acquired von Willebrand factor deficiency?
This review highlights the theoretical risk of acquired von Willebrand factor deficiency in patients with patient-prosthesis mismatch after aortic valve replacement due to high shear forces.
Acquired von Willebrand factor deficiency has been described in patients with aortic valve stenosis due to high shear forces developed during passage through the narrowed valve orifice, which determines structural changes in this molecule. Similar flow conditions are present in patients with an aortic prosthesis that presents a patient-prosthesis mismatch. Patient-prosthesis mismatch is described by the smaller effective orifice area of the prosthesis than the native valve, which would probably determine similar changes in the molecules of the von Willebrand factor, leading to acquiring von Willebrand deficiency.
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Grigorescu et al. (2023) conducted a review in Patient-prosthesis mismatch after aortic valve replacement. Patient-prosthesis mismatch after aortic valve replacement creates high shear forces similar to aortic stenosis, which likely leads to acquired von Willebrand factor deficiency.
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