PMC6240727_01
Preoperative echocardiography showing severe aortic stenosis.
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Echocardiography showed severe AS, with a peak aortic pressure gradient of 88.0 mmHg and effective orifice area of 0.52 cm2 (Fig. 1).
Multimer analysis of von Willebrand factor before aortic valve replacement.
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Although the serum level of von Willebrand factor (vWF) activity was in the normal lower limit of 51% (normal range 50-150%), further hematologic examination by gel electrophoresis showed deficiency of high-molecular-weight multimers of vWF (Fig. 2).
Clinical course and transition of hemoglobin levels. PAD, post-admission day; SAVR, surgical aortic valve replacement. Black arrow, red blood cell transfusion.
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Under anticoagulant control of prothrombin time-international normalized ratio at 2.0-2.5, the patient did not develop recurrent anemia in the perioperative period (Fig. 3).