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このアイテムの引用には次の識別子を使用してください: http://hdl.handle.net/10564/3328

タイトル: Rapid Restoration of Thrombus Formation and High-Molecular-Weight von Willebrand Factor Multimers in Patients with Severe Aortic Stenosis After Valve Replacement.
その他のタイトル: 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
著者: Yamashita, Keigo
Yagi, Hideo
Hayakawa, Masaki
Abe, Takehisa
Hayata, Yoshihiro
Yamaguchi, Naoko
Sugimoto, Mitsuhiko
Fujimura, Yoshihiro
Matsumoto, Masanori
Taniguchi, Shigeki
キーワード: Aortic valve stenosis
Acquired von Willebrand syndrome
Thrombus formation
ADAMTS13
発行日: 2016年10月1日
出版者: 日本動脈硬化学会
引用: Journal of atherosclerosis and thrombosis Vol.23 No.10 p.1150-1158 (2016 Oct)
抄録: 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.
内容記述: 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.
URI: http://hdl.handle.net/10564/3328
ISSN: 13403478
学位授与番号: 24601B1395
学位授与年月日: 2017-03-15
学位名: 博士(医学)
学位授与機関: 奈良県立医科大学
出現コレクション:2016年度

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