Speed Reduction Does Not Restore High Molecular Weight von Willebrand Multimers During HeartMate II Support: An In Vivo Study

ASAIO J. 2018 Sep/Oct;64(5):e123-e125. doi: 10.1097/MAT.0000000000000831.

Abstract

Acquired von Willebrand Syndrome (AVWS) in patients undergoing continuous-flow left ventricular assist device support is due to the loss of von Willebrand factor (vWF) high molecular weight multimers (HMWMs) by shear-mediated mechanisms. We investigated whether reducing speed in vivo would mitigate the shear effect. In outpatients (n = 6) with a HeartMate II, pump speed was decreased to 8,000 rpm for 6 hours. At baseline (9,140 ± 189 rpm), patients had an AVWS as evidenced by low vWF activity:antigen ratios (0.58 ± 0.13, normal >0.7) and reduced HMWMs. After 6 hours, there was no significant change in either the vWF activity:antigen ratio or the HMWMs. Decreasing pump speed does not ameliorate AVWS.

MeSH terms

  • Adult
  • Aged
  • Female
  • Heart-Assist Devices / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Molecular Weight
  • von Willebrand Diseases / etiology*
  • von Willebrand Factor / chemistry*

Substances

  • von Willebrand Factor