Browsing by Subject "Factor XII"

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    Contact pathway in surgical and transcatheter aortic valve replacement
    (Frontiers Media, 2022-07-22) Morena Barrio, María Eugenia de la; Corral, Javier; López García, Cecilia; Jiménez Díaz, Víctor Alonso; Miñano, Antonia; Juan-Salvadores, Pablo; Esteve Pastor, María Asunción; Baz Alonso, José Antonio; Rubio, Ana María; Sarabia Tirado, Francisco; García Navarro, Miguel; García Lara, Juan; Marín, Francisco; Vicente, Vicente; Pinar, Eduardo; Cánovas López, Sergio; Morena, Gonzalo de la; Cirugía, Pediatría y Obstetricia y Ginecología
    Background: Aortic valve replacement is the gold standard treatment for severe symptomatic aortic stenosis, but thrombosis of bioprosthetic valves (PVT) remains a concern. Objective: To analyze the factors involved in the contact pathway during aortic valve replacement and to assess their impact on the development of thromboembolic complications. Methods: The study was conducted in 232 consecutive patients who underwent: transcatheter aortic valve replacement (TAVR, N = 155), and surgical valve replacement (SAVR, N = 77) (MUVITAVI project). Demographic and clinical data, outcomes including a combined end point (CEP) of thrombotic events, and imaging controls were recruited. Samples were collected 24 h before and 48 h after valve replacement. FXII, FXI and (pre)kallikrein were evaluated by Western Blot and specific ELISA with nanobodies. Results: The CEP of thrombotic events was reached by 19 patients: 13 patients presented systemic embolic events and 6 patients subclinical PVT. Valve replacement did not cause FXII activation or generation of kallikrein. There was a significant reduction of FXI levels associated with the procedure, which was statistically more pronounced in SAVR than in TAVR. Cases with reductions of FXI below 80% of basal values had a lower incidence of embolic events during the procedure than patients in whom FXI increased above 150%: 2.7 vs. 16.7%; p: 0.04. Conclusion: TAVR or SAVR did not significantly activate the contact pathway. A significant reduction of FXI, was observed, particularly in SAVR, associated with lower incidence of thrombotic events. These results encourage evaluating the usefulness and safety of FXI-directed antithrombotic treatments in these patients.