Publication: Contact pathway in surgical and transcatheter aortic valve replacement
Authors
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
item.page.secondaryauthor
item.page.director
Publisher
Frontiers Media
publication.page.editor
publication.page.department
DOI
https://doi.org/10.3389/fcvm.2022.887664
item.page.type
info:eu-repo/semantics/article
Description
© 2022 de la Morena-Barrio, Corral, López-García, Jiménez-Díaz, Miñano,
Juan-Salvadores, Esteve-Pastor, Baz-Alonso, Rubio, Sarabia-Tirado,
García-Navarro, García-Lara, Marín, Vicente, Pinar, Cánovas and de la
Morena. This manuscript version is made available under the CC-BY 4.0 license http://creativecommons.org/licenses/by/4.0. This document is the Published version of a Published Work that appeared in final form in Frontiers in Cardiovascular Medicine. To access the final edited and published work see https://doi.org/10.3389/fcvm.2022.887664
Abstract
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.
publication.page.subject
Citation
Front. Cardiovasc. Med. 9:887664
item.page.embargo
Collections
Ir a Estadísticas
Este ítem está sujeto a una licencia Creative Commons. http://creativecommons.org/licenses/by/4.0/