Von Willebrand Factor Multimers in Aortic Stenosis Surgery: Dynamics and Disease Correlation

The preoperative to early remote postoperative von Willebrand factor (VWF) large multimer index (LMI) in patients with aortic stenosis (AS) remains unclear. Assessment of LMI changes may be better understood if other valvular diseases are integrated. However, this association requires further investigation.

A quantitative time-course assessment of the VWF, including LMI, was performed in 23 patients with AS who underwent aortic valve replacement. The proposed total valve score was used to study the correlation between the LMI and valvular diseases, including diseases other than AS.

The postoperative VWF LMI was significantly higher; this increase was sustained across nine measurements up to one year postoperatively. The total valve score showed a moderate negative correlation with the VWF LMI (Spearman correlation coefficient r_s = -0.5483, p = 0.0068), demonstrating a stronger negative correlation and a lower p-value than the peak flow velocity and mean pressure gradient.

Improved VWF LMI was maintained one year after AS surgery and correlated better with echocardiographic severity when considering other valvular diseases than AS severity alone. VWF LMI may indicate overall cardiac shear stress and treatment effectiveness in early remote stages.