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Dec 6, 2019 · Surgical procedures represent a serious hemostatic challenge for patients with von Willebrand disease (VWD), and careful perioperative management is required to minimize bleeding risk. Risk stratification includes not only the nature of the surgery to be performed but the baseline plasma von Willebrand factor (VWF) levels, bleeding history, and ...
- James S. O’Donnell, Michelle Lavin
- 2019
Jan 1, 2022 · Introduction. von Willebrand disease (VWD) is the most common inherited bleeding disorder and is the result of either quantitative (Type 1 and Type 3) or qualitative defects (Type 2) in von Willebrand factor (VWF). 1 Patients with VWD are at particular risk of hemorrhage in the perioperative setting, given the key role of VWF in both hemostasis 2 and wound healing. 3 This risk depends on the ...
- 10.1182/bloodadvances.2021005666
- 2022/01/01
- Blood Adv. 2022 Jan 11; 6(1): 121-128.
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- Abstract
- Pathophysiology
- Epidemiology
- Classification and Genetics
- Diagnosis
- Treatment
- Clinical Case
- Discussion
- Conclusion
The safety of highly vascular and invasive plastic surgery procedures is dependent on an intact and functionally normal coagulation system. Intraoperative and postoperative bleeding complications not only threaten the integrity of any cosmetic or functional result, but also, on rare occasions, they may prove life threatening to the patient as well....
Pro-vWF, a 2791 amino acid propeptide, is the primary translation product of the vWF gene synthesized by endothelial cells and megakaryocytes. Posttranslational processing cleaves the pro-vWF peptide into the vWF propeptide (vWF antigen), which is released into plasma, and the mature vWF peptide (a 230-kd monomer).1,2 Monomers of mature vWF are ass...
VWD is the most common inherited bleeding disorder. Prevalence is estimated at 1% to 2% and appears equally in both sexes and across all racial groups. However, heterogeneity and variable expression may cause the actual prevalence of vWD to be severely underestimated. It is likely that many cases of mild vWD remain undiagnosed barring major clinica...
The vWF gene is located on chromosome 12p and contains 52 exons.20–23 Congenital vWD has been subdivided on the basis of qualitative or quantitative deficiencies of vWF.16 There are 3 primary types of vWD. Type 1 is associated with mildly decreased levels of vWF, type 2 involves qualitative vWF deficiency, and type 3 is characterized by a virtual a...
The diagnosis of vWD requires attention to both clinical and laboratory components. Pertinent clinical information includes a positive family history and a history of excessive mucocutaneous bleeding. These symptoms may include epistaxis, menorrhagia, ecchymosis, gingival bleeding, and excessive surgical bleeding.35 Although petechiae are more ofte...
The most important factor in the management of vWD is the accurate detection of the type and severity of the disease. The goal of therapy is to normalize the decreased platelet adhesion characteristic of vWD, as well as the decreased FVIII plasma levels, when present. Two primary options are available for the treatment of vWD, desmopressin (DDAVP) ...
A 57-year-old woman underwent rhytidectomy and full-face laser in 1996; her postoperative course was complicated with a hematoma recognized on postoperative day 1. Subsequently, the patient was taken to the operating room for hematoma evacuation. The patient's preoperative laboratory values were all within normal limits, and her anesthesia and post...
VWD was first described by Eric von Willebrand in 1926.63Since then several subgroups of this disease have been described. The goal of this article is to demonstrate the importance of being familiar with this disease, and the potential problems that vWD may cause in plastic surgery patients. While the literature notes the prevalence of vWD in the p...
Given the prevalence of vWD, it is essential for plastic surgeons to become familiar with this disorder and its diagnosis and contemporary management. Familiarity with vWD will lead to increased patient safety and better surgical and cosmetic outcomes. Although DDAVP could be helpful to minimize the bleeding with unknown origin during surgery or th...
- Ali Totonchi, Yashar Eshraghi, Daniel Beck, Keith McCrae, Bahman Guyuron
- 2008
Sep 13, 2016 · Von Willebrand disease – the ‘Dos’ and ‘Don'ts’ in surgery - Miesbach - 2017 - European Journal of Haematology - Wiley Online Library. Original Article.
- Wolfgang Miesbach, Erik Berntorp
- 2017
For more information on the ASH, ISTH, NHF, and WFH guidelines for von Willebrand disease, please visit wwwerene ASH ISTH NHF WFH 2021 guidelines on the management of von Willebrand disease Background Objective Methods Results Conclusions Subjects Topics Von Willebrand disease (VWD) is a common inherited bleeding disorder. Significant ...
Jan 12, 2021 · This inherited condition results in the decreased production, absence, or abnormal function of the clotting protein von Willebrand factor. VWD can cause unusual bleeding from small wounds or minor procedures, frequent nosebleeds, bruising, bleeding in joints, and heavy menstrual periods and post-partum bleeding in women.
Jun 4, 2020 · von Willebrand disease (VWD) is the most common inherited bleeding disorder characterised by a quantitative or qualitative deficiency in von Willebrand factor (VWF). During invasive surgical procedures, patients with VWD require additional treatment to maintain haemostasis; however, due to the complexity of VWD, there is a lack of consensus on ...
