ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Structural Interventional Cardiology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1576921
Pre-Procedural Abnormal von Willebrand Factor Function Predicts Clinical Outcomes After Transcatheter Aortic Valve Implantation: A Prospective Study
Provisionally accepted
Haitham Abu Khadija
Mohammad Alnees*Omar AyyadGera Gandelman
Nizar Abu HamdehAmir HaimYazan HamdanRamon CohenDuha NajajraAlena Kirzhner
Tal SchillerJacob GeorgeAlex Blatt- Kaplan Medical Center, Rehovot, Israel
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Background and Objectives: Transcatheter Aortic Valve Implantation (TAVI) is a minimally invasive intervention for aortic stenosis, which is associated with the potential for major vascular complications and arrhythmias. This study aims to identify primary predictors of these complications, emphasizing the roles of Decreased Platelet Count (DPC) and Acquired Von Willebrand Syndrome (AVWS).We performed a prospective study with 80 patients planning to receive TAVI at the Heart Center, Kaplan Medical Center, Rehovot, Israel. Pre-procedural evaluations include the measurement of baseline platelet counts and the functionality of the von Willebrand factor. The DPC was determined as the percentage decreased from baseline to the lowest count. AVWS was diagnosed through the assessment of von Willebrand factor activity and antigen concentrations.Our results demonstrate that both DPC and AVWS are crucial predictors of major vascular complications. Specifically, patients with a DPC exceeding 20% exhibited an odds ratio (OR) of 4.816365 (95% CI: [1.0100, 22.9674], p = 0.049) for complications. While, patients with abnormal von Willebrand factor function presented an OR of 9.84373 (95% CI: [1.601388-15.50941], p = 0.014) for complications compared to those without AVWS. ROC curve analysis indicated an AUC of 0.7417 for the DPC model and 0.8025 for the AVWS model in predicting major vascular complications. In the arrhythmia model, AVWS appeared as a significant predictor of arrhythmias, with an OR of 4.480 (95% CI: [1.21, 16.49], p = 0.024).Assessing both DPC and von Willebrand factor function is crucial for predicting post-TAVI complications.
Keywords: Transcatheter aortic valve implantation (TAVI), Acquired von willebrand syndrome (AvWS), Platelet Count, Major Vascular Complications, Predictive Modeling
Received: 14 Feb 2025; Accepted: 08 May 2025.
Copyright: © 2025 Abu Khadija, Alnees, Ayyad, Gandelman, Abu Hamdeh, Haim, Hamdan, Cohen, Najajra, Kirzhner, Schiller, George and Blatt. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mohammad Alnees, Kaplan Medical Center, Rehovot, Israel
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