Increased bleeding risk in patients with aortic valvular stenosis: From new mechanisms to new therapies

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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
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Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

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Joanna Natorska1, Piotr Mazur1, Anetta Undas1

  • 1Institute of Cardiology, Jagiellonian University School of Medicine, Krakow, Poland; John Paul II Hospital, Krakow, Poland.

Thrombosis Research
|February 27, 2016
PubMed

Insights

Aortic stenosis (AS) patients often experience bleeding due to coagulopathy. This review explores AS bleeding mechanisms, compensatory factors, and treatment impacts, offering insights into coagulation regulation.

Area of Science:

  • Cardiology
  • Hematology
  • Valvular Heart Disease

Background:

  • Aortic stenosis (AS) is the most common acquired adult valvular heart disease.
  • Coexisting coagulopathy leads to bleeding in approximately 20% of AS patients.
  • Understanding AS-related bleeding is crucial for patient management.

Purpose of the Study:

  • To review the mechanisms of bleeding tendency in aortic stenosis.
  • To discuss compensatory mechanisms that prevent bleeding in most severe AS patients.
  • To provide an update on Heyde's syndrome and emerging concepts in AS coagulation.

Main Methods:

  • Comprehensive literature review.
  • Analysis of pathobiology of AS-related bleeding.
  • Evaluation of coagulation regulation in AS.
  • Assessment of valvular intervention impacts on coagulation.

Main Results:

  • Detailed summary of bleeding mechanisms and compensatory pathways in AS.
  • Updated insights into Heyde's syndrome and novel coagulation concepts.
  • Discussion on how surgical valve replacement and TAVI affect coagulation abnormalities.

Conclusions:

  • Valvular interventions significantly impact coagulation abnormalities in AS.
  • Current treatment recommendations for AS-related bleeding are discussed.
  • Further research into coagulation regulation in AS is warranted.

Keywords:
Aortic stenosisBleedingCoagulationHeyde syndromeValve replacementvon Willebrand factor

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