Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.

• Material Type: 博士論文
• Title: Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.
• Author/Editor: Yamashita, Keigo; Yagi, Hideo; Hayakawa, Masaki; Abe, Takehisa; Hayata, Yoshihiro; Yamaguchi, Naoko; Sugimoto, Mitsuhiko; Fujimura, Yoshihiro; Matsumoto, Masanori; Taniguchi, Shigeki
• Author Heading: Yamashita, Keigo; Yagi, Hideo; Hayakawa, Masaki; Abe, Takehisa; Hayata, Yoshihiro; Yamaguchi, Naoko; Sugimoto, Mitsuhiko; Fujimura, Yoshihiro; Matsumoto, Masanori; Taniguchi, Shigeki
• Publication, Distribution, etc.: 日本動脈硬化学会
• Publication Date: 2016-10-01
• Publication Date (W3CDTF): 2016-10-01
• Alternative Title: 重度大動脈弁狭窄症患者の大動脈弁置換術後における血小板機能および高分子量 von Willebrand 因子多量体の急速な回復
• Periodical title: Journal of atherosclerosis and thrombosis
• No. or year of volume/issue: 23 10
• Volume: 23
• Issue: 10
• Pages: 1150-1158
• ISSN (Periodical Title): ISSN : 1340-3478
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2017-03-15
• Dissertation Number: 乙第1395号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Subject Heading: Aortic valve stenosis; Acquired von Willebrand syndrome; Thrombus formation; ADAMTS13
• Target Audience: 一般
• Note (General): type:Thesis; AIM: Patients with severe aortic stenosis (AS) may have bleeding episodes due to the loss of high-molecular-weight (HMW) von Willebrand factor multimers (VWFMs). The absence of HMW-VWFMs and bleeding tendency are usually corrected after aortic valve replacement (AVR). To investigate the process of VWFM recovery and symptoms in patients with severe AS, we analyzed changes in VWF antigen (VWF:Ag), ADAMTS13 activity (ADAMTS13:AC), and platelet thrombus formation under high shear stress conditions. METHODS: Nine patients with severe AS undergoing AVR were analyzed. RESULTS: Evident deficiency of HMW-VWFMs was observed in six patients before surgery, which was rapidly restored within 8 days after AVR. Median levels of VWF:Ag before surgery, on postoperative days (PODs) 1, 8, 15, and 22, and one year after AVR were 78.1%, 130%, 224%, 155%, 134%, and 142%, respectively. In contrast, ADAMTS13:AC was 50.5%, 35.5%, 25.5%, 25.1%, 30.3%, and 84.6%, respectively. Preoperative thrombus formation but not surface coverage was significantly lower than that on POD 22, which was considered as normal level in each patient. Compared with preoperative levels, thrombus volume was significantly lower on POD 1, but rapidly increased by POD 8. CONCLUSION: Bleeding tendency and loss of HMW-VWFMs observed in patients with severe AS before surgery was rapidly corrected after AVR. Instead, patients were in a VWF-predominant state between POD 8 and 22.; 博士（医学）・乙第1395号・平成29年3月15日; Copyright © 2016 Japan Atherosclerosis Society; 本論文の著作権は日本動脈硬化学会が保持しています。; This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.; identifier:Journal of atherosclerosis and thrombosis Vol.23 No.10 p.1150-1158 (2016 Oct); identifier:13403478; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/3328; identifier:Journal of atherosclerosis and thrombosis, 23(10): 1150-1158
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.5551/jat.34421
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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http://ginmu.naramed-u.ac.jp/dspace/bitstream/10564/3328/1/01_%e4%b9%991395%e6%9c%ac%e6%96%87%e3%81%ae%e8%a6%81%e6%97%a8.pdf fulltext

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