Treatment of Acquired von Willebrand Syndrome in Aortic Stenosis and Left Ventricular Assist Device

Acquired von Willebrand syndrome (AvWS) can arise as a direct consequence of cardiovascular mechanical disorders. In patients with aortic stenosis or a left ventricular assist device (LVAD), high shear stress across the abnormal valve or pump leads to proteolysis of high-molecular-weight vWF multimers, impairing primary haemostasis and creating a clinically significant bleeding risk.

This protocol targets AvWS specifically in the cardiovascular disorder population — patients with aortic stenosis or an LVAD in whom the underlying haemodynamic mechanism drives ongoing vWF degradation. The approach must account for both the acute haemostatic deficit and the possibility of addressing the root cardiovascular cause.

Management centres on haemostatic factor concentrate replacement for acute bleeding episodes. Additional agents and the strategy for definitive cardiovascular correction are part of the full protocol — sequencing, clinical decision points, and the complete set of options are not shown here.