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Correspondence
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Volume 349:1773-1774 October 30, 2003 Number 18
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Aortic Stenosis, von Willebrand Factor, and Bleeding

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 by Vincentelli, A.
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To the Editor: We have a concern regarding the report by Vincentelli et al. (July 24 issue)1 on acquired von Willebrand syndrome in aortic stenosis. What is the true clinical relevance of the documented laboratory findings? In their study, 9 of 42 patients (21 percent) had bleeding symptoms, whereas 67 to 92 percent had hemostatic abnormalities that were consistent with the presence of acquired von Willebrand syndrome. We studied 10 patients (mean age, 73 years) with severe aortic stenosis (mean transvalvular gradient greater than 51 mm Hg) before aortic-valve replacement. One of them had mild mucocutaneous bleeding and a type . . . [Full Text of this Article]


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