Acquired von Willebrand Syndrome Associated with Mitral Regurgitation

Acquired von Willebrand syndrome (AvWS) has been observed in patients with aortic stenosis. To determine whether it is also associated with mitral regurgitation, investigators prospectively examined 53 patients with mild (13), moderate (14), or severe (26) mitral disease.

Significant reductions of platelet aggregation, the ratios of von Willebrand factor (vWF) latex activity to vWF antigen, and vWF multimers were observed with increasing severity of mitral regurgitation (P<0.001 for all). Nine patients had clinically significant bleeding, including seven with the Heyde syndrome (gastrointestinal bleeding due to angiodysplasia and transfusion dependency). Patients with a history of bleeding were more likely to have severe mitral regurgitation…